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晚年的多重疾病自我报告是否预示着身体机能受损,这在临床实践中是否有用?

Does self-report of multimorbidity in later life predict impaired physical functioning, and might this be useful in clinical practice?

机构信息

MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.

National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, OX3 7LE, UK.

出版信息

Aging Clin Exp Res. 2020 Aug;32(8):1443-1450. doi: 10.1007/s40520-020-01500-8. Epub 2020 Feb 13.

Abstract

BACKGROUND

Multimorbidity has been shown in several studies to relate to impaired physical function in later life.

AIMS

To examine if self-report of multimorbidity predicts impaired physical functioning, as assessed by formal physical function testing, in community-dwelling older adults.

METHODS

Non-communicable diseases (NCDs) were self-reported by 443 older community-dwelling UK adults via questionnaire, asking the question: 'Have you been told by a doctor that you have any of the following conditions?' Assessments of walking speed, chair stands and balance allowed us to create a composite score (0-12) on which impaired physical functioning was defined as ≤ 9.

RESULTS

The mean age of participants was 75.5 ± 2.5 years for men and 75.8 ± 2.6 for women. The proportion of individuals with impaired physical functioning was 71.2% in women and 56.9% in men. Having four or more NCDs was associated with an increased risk of poor physical function in men and women (p < 0.05). The number of medications and medicated systems was associated with gait speed (p < 0.03 and < 0.02, respectively) and timed up-and-go tests (p < 0.03 and < 0.02, respectively) in women but not men.

DISCUSSION AND CONCLUSION

Self-report of 4 or more NCDs was associated with an increased risk of poor physical function, an outcome which has previously been associated with adverse clinical sequelae. This observation may inform development of a simple screening tool to look for poor physical function in older adults.

摘要

背景

多项研究表明,多种疾病与老年人的身体机能受损有关。

目的

研究自我报告的多种疾病是否预示着社区居住的老年人身体机能受损,通过正式的身体功能测试来评估。

方法

通过问卷调查,443 名英国社区居住的老年人报告了非传染性疾病(NCDs),问题是:“医生是否告诉您患有以下任何一种疾病?”评估行走速度、椅子站立和平衡能力,使我们能够创建一个综合得分(0-12),身体机能受损定义为≤9。

结果

参与者的平均年龄为男性 75.5±2.5 岁,女性 75.8±2.6 岁。女性中身体机能受损的比例为 71.2%,男性为 56.9%。男性和女性中患有四种或更多种 NCDs 与身体机能较差的风险增加相关(p<0.05)。用药数量和用药系统与女性的步态速度(p<0.03 和 p<0.02)和计时起立行走测试(p<0.03 和 p<0.02)相关,但与男性无关。

讨论与结论

自我报告的四种或更多种 NCDs 与身体机能较差的风险增加相关,这一结果以前与不良临床后果相关。这一观察结果可能为开发一种简单的筛查工具提供信息,以寻找老年人的身体机能较差。

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Polypharmacy and Gait Performance in Community-dwelling Older Adults.社区居住老年人的多重用药与步态表现
J Am Geriatr Soc. 2017 Sep;65(9):2082-2087. doi: 10.1111/jgs.14957. Epub 2017 Jun 26.

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