目的：在泰国老年人群的代表性研究中，评估客观身体测量指标与主观功能限制的关联。
Objective physical measures and their association with subjective functional limitations in a representative study population of older Thais.
机构信息
College of Population Studies, Chulalongkorn University, Bangkok, 10330, Thailand.
Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/OEAW, WU), International Institute for Applied Systems Analysis (IIASA), 2361, Laxenburg, Austria.
出版信息
BMC Geriatr. 2019 Mar 5;19(1):73. doi: 10.1186/s12877-019-1093-3.
BACKGROUND
In this study, we analyzed elderly people in Thailand to identify the validity of suggested cutoff points of physical measures, handgrip strength, usual walking speed, and a composite score of both measures to predict functional limitations. Moreover, we examined whether these physical performance measures are accurate indicators of the investigated health outcomes.
METHODS
Using Receiver Operating Characteristics (ROC) analysis, we investigated a sample of 8272 respondents aged 60 to 79 years. All data were based on the 2009 National Health Examination Survey (NHES IV) of Thailand.
RESULTS
For males aged 60 to 69 years, handgrip strength was used as an indicator of functional limitations. The cutoff point for disabilities in the activities of daily living (ADLs) was 29.5 kg, while in other limitations it ranged from 28.7 to 31.3 kg. In contrast, usual walking speed was able to indicate ADL disabilities at 0.7 m per second (m/s). As one might expect, the cutoff points for males aged 70 to 79 years were lower than for males in the 60 to 69 age group. For females, handgrip strength was able to indicate ADL disabilities at 16.5 kg for both the 60 to 69, and 70 to 79 age groups. Likewise, walking speed was indicative of ADL disabilities at 0.6 m/s for both age groups. Interestingly, the composite measure increases the ability to detect ADL disabilities in the younger group but not in the older group. The area under the curve (AUC) of cutoffs measuring the detection power of a diagnostic test was varied, ranging from 0.535 to 0.7386.
CONCLUSIONS
The cutoff points of three measures varied according to sex and type of functional limitations. Our findings also showed that physical performance measures were useful for identifying people with an increased risk of functional limitations, particularly for ADL disabilities. However, although the AUC of the cutoffs of other functional limitations were relatively low, they should be considered with caution.
背景
本研究旨在分析泰国老年人，以确定身体测量、握力、日常行走速度以及这两种测量的综合评分预测功能障碍的建议切点的有效性。此外，我们还研究了这些身体表现测量是否准确地反映了所研究的健康结果。
方法
我们使用接收者操作特性（ROC）分析了年龄在 60 至 79 岁的 8272 名受访者的样本。所有数据均基于泰国 2009 年国家健康检查调查（NHES IV）。
结果
对于 60 至 69 岁的男性，握力被用作功能障碍的指标。日常生活活动（ADL）残疾的截断点为 29.5 千克，而在其他限制中，截断点范围为 28.7 至 31.3 千克。相比之下，日常行走速度为 0.7 米/秒（m/s）时可指示 ADL 残疾。正如人们所料，70 至 79 岁男性的截断点低于 60 至 69 岁男性。对于女性，60 至 69 岁和 70 至 79 岁年龄组的握力都为 16.5 千克时可指示 ADL 残疾。同样，行走速度为 0.6 m/s 时，两个年龄组都指示 ADL 残疾。有趣的是，在年轻组中，综合测量提高了检测 ADL 残疾的能力，但在老年组中却没有。用于检测诊断测试检测能力的截止值的曲线下面积（AUC）各不相同，范围从 0.535 到 0.7386。
结论
三个测量的截止点根据性别和功能障碍类型而有所不同。我们的研究结果还表明，身体表现测量对于识别功能障碍风险增加的人群非常有用，尤其是日常生活活动障碍。但是，尽管其他功能障碍的截止值 AUC 相对较低，但仍应谨慎考虑。
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