Karvonen-Gutierrez Carrie A
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Room 6618, Ann Arbor, MI 48109 USA.
Womens Midlife Health. 2015 Oct 14;1:10. doi: 10.1186/s40695-015-0011-x. eCollection 2015.
Data suggest that disability prevalence among mid-aged populations is increasing in recent years; current prevalence estimates for mid-aged adults range from 20 to 40 %. The World Health Organization's International Classification of Functioning (ICF) has provided a multi-dimensional biopsychosocial model to understand disability that is highly relevant to mid-aged populations. Under the ICF framework, mid-aged women experience high levels of work, non-work, and mobility-associated disability but very little difficulty with self care. Despite the high prevalence, evidence suggests that there is a large proportion of non-chronic disability and that mid-aged women can both worsen and improve their functioning. Thus, the mid-life period may represent a critical window during which interventions to improve disability may be most efficacious for the improvement of current and future functioning. Interventions that are initiated during the mid-life are highly relevant as a strategy to reduce disability during this life stage and prevent or forestall the onset of late life disability. Targets for intervention include improvement of depressive symptoms and increasing physical activity levels, both of which have shown to be efficacious in older populations and are correlates of mid-life functioning and disability.
数据表明,近年来中年人群中的残疾患病率呈上升趋势;目前对中年成年人的患病率估计在20%至40%之间。世界卫生组织的《国际功能、残疾和健康分类》(ICF)提供了一个多维的生物心理社会模型来理解残疾,这与中年人群高度相关。在ICF框架下,中年女性在工作、非工作以及与行动相关的残疾方面存在较高水平,但在自我护理方面困难较小。尽管患病率很高,但有证据表明,很大一部分残疾并非慢性,而且中年女性的功能既可能恶化也可能改善。因此,中年时期可能是一个关键窗口,在此期间进行改善残疾状况的干预措施,对于改善当前和未来的功能可能最为有效。在中年时期开始的干预措施,作为减少这一生命阶段残疾并预防或延缓晚年残疾发生的策略,具有高度相关性。干预目标包括改善抑郁症状和提高身体活动水平,这两者在老年人群中已被证明是有效的,并且与中年功能和残疾相关。