Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, The Netherlands.
Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Eur J Public Health. 2019 Dec 1;29(6):1096-1102. doi: 10.1093/eurpub/ckz065.
Monitoring of trends in functioning of older adults provides indispensable information for health care policy. This study examined trends in multiple indicators of functioning among Dutch older adults across a period of 20 years.
Data from the Longitudinal Aging Study Amsterdam were used. We included 10 870 observations of 3803 respondents aged 64-84 years across seven waves (1992-12) and 931 observations of 603 respondents aged 85-94 years across four waves (2001-12). At each wave, 8 indicators of functioning were measured: multimorbidity, severe functional limitations, depression, anxiety, cognitive impairment, physical inactivity, loneliness and social isolation. In addition, a sum score (range: 0-8) of these indicators was calculated, with a score of ≥5 indicating 'multiple problems.' Trends in functioning over time were assessed using Generalized Estimating Equation analyses.
In the 64-84-years-olds, the prevalence of multimorbidity increased over time [OR(year) = 1.06, 95% CI = 1.05-1.06], whereas the prevalence of the other indicators decreased [i.e. cognitive impairment, physical inactivity (in women) and loneliness (in women)] or remained stable [i.e. severe functional limitations, depression, anxiety, physical inactivity (in men), loneliness (in men) and social isolation]. In the 85-94-year-olds, the prevalence of severe functional limitations increased over time [OR(year) = 1.08, 95% CI = 1.02-1.13], whereas the prevalence of the other indicators remained stable. In both age groups, the prevalence of 'multiple problems' remained stable.
Unfavorable trends were observed in multimorbidity among 64-84-years-olds and in severe functional limitations among 85-94-year-olds. Favorable trends were found in cognitive impairment, physical inactivity (in women) and loneliness (in women) among 64-84-years-olds.
监测老年人功能变化趋势为医疗保健政策提供了不可或缺的信息。本研究调查了荷兰老年人在 20 年间多项功能指标的变化趋势。
使用阿姆斯特丹纵向老龄化研究的数据。我们纳入了跨越 7 个波次（1992-12 年）的 3803 名 64-84 岁受访者的 10870 次观察和跨越 4 个波次（2001-12 年）的 603 名 85-94 岁受访者的 931 次观察。在每个波次，我们测量了 8 项功能指标：多种合并症、严重功能障碍、抑郁、焦虑、认知障碍、身体不活动、孤独和社会隔离。此外，我们还计算了这些指标的综合评分（范围：0-8），得分≥5 表示“存在多种问题”。我们使用广义估计方程分析评估了随时间推移的功能变化趋势。
在 64-84 岁年龄组中，多种合并症的患病率随时间推移而增加[比值比（OR）（年）=1.06，95%置信区间（CI）=1.05-1.06]，而其他指标的患病率则下降[即认知障碍、身体不活动（女性）和孤独（女性）]或保持稳定[即严重功能障碍、抑郁、焦虑、身体不活动（男性）、孤独（男性）和社会隔离]。在 85-94 岁年龄组中，严重功能障碍的患病率随时间推移而增加[OR（年）=1.08，95% CI = 1.02-1.13]，而其他指标的患病率保持稳定。在两个年龄组中，“存在多种问题”的患病率均保持稳定。
在 64-84 岁年龄组中观察到多种合并症的不利趋势，在 85-94 岁年龄组中观察到严重功能障碍的不利趋势。在 64-84 岁年龄组中，我们发现认知障碍、身体不活动（女性）和孤独（女性）方面呈现有利趋势。
