School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada; Department of Chiropractic, Macquarie University, Sydney, Australia.
J Am Med Dir Assoc. 2019 Oct;20(10):1199-1205.e4. doi: 10.1016/j.jamda.2019.04.014. Epub 2019 May 31.
We examined the lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories.
Longitudinal analysis of an international cohort study.
Older adults from the International Mobility in Aging Study (IMIAS) aged between 65 and 74 years at baseline.
Physical performance of the lower extremities was measured in 2012, with follow-ups in 2014 and in 2016, using the Short Physical Performance Battery (SPPB). Group-based trajectory analysis of physical performance by gender was performed. Multinomial logistic regression was used to derive relative risk ratios with 95% confidence intervals between the physical performance trajectories and the potential baseline predictors in men and women separately.
Three physical performance trajectories were identified in men and women: high-stable (30.0% vs 35.5%), gradual functional decline (63.1% vs 54.3%), and rapid functional decline (6.9% vs 10.2%). Common baseline characteristics associated with memberships in the gradual functional decline and rapid functional decline trajectory groups in men and women were age, single marital status, and multiple chronic conditions (>3). Among men, depression was a strong predictor of the membership in the rapid functional decline trajectory group. Women in the rapid functional decline trajectory group were more likely to be obese, with feminine and undifferentiated gender roles, and have poor self-rated health at baseline.
CONCLUSIONS/IMPLICATIONS: There are gender differences in the physical performance trajectories and related factors among older adults. Programs aiming at preventing or slowing functional decline in old age should be sensitive to gender.
我们研究了 4 年内老年男性和女性下肢功能的轨迹及其基线预测因素。
一项国际队列研究的纵向分析。
国际老龄化迁移研究(IMIAS)中年龄在 65 至 74 岁之间的老年人。
使用简短身体表现电池(SPPB)在 2012 年测量下肢的身体表现,并在 2014 年和 2016 年进行随访。根据性别对身体表现进行基于组的轨迹分析。使用多变量逻辑回归分别在男性和女性中,根据潜在的基线预测因素,导出身体表现轨迹与相对风险比及其 95%置信区间。
在男性和女性中确定了三种身体表现轨迹:高稳定(30.0%对 35.5%)、逐渐功能下降(63.1%对 54.3%)和快速功能下降(6.9%对 10.2%)。与男性和女性中逐渐功能下降和快速功能下降轨迹组的成员身份相关的常见基线特征是年龄、单身婚姻状况和多种慢性疾病(>3)。在男性中,抑郁是快速功能下降轨迹组成员的一个强烈预测因素。快速功能下降轨迹组的女性更有可能肥胖,具有女性化和未分化的性别角色,以及较差的自我评估健康状况。
结论/意义:老年男性和女性的身体表现轨迹及其相关因素存在性别差异。旨在预防或减缓老年功能下降的计划应针对性别敏感。