Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium.
Department of Quantitative Genetics, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
Age Ageing. 2020 Aug 24;49(5):800-806. doi: 10.1093/ageing/afaa034.
Previous studies have shown that older people can experience a considerable change in their physical performance (PP) over time.
To identify PP trajectories and their association with mortality among nursing home residents who were followed up for 3 years.
Three-year longitudinal observational study.
Subjects of the SENIOR cohort.
Six hundred and four nursing home residents with a mean age of 82.9 ± 9.1 years.
Baseline characteristics and the date of death were collected from the medical records. PP was assessed annually by the short physical performance battery (SPPB) test. Multiple imputations were performed to manage the missing data. PP trajectory groups were estimated using latent growth curve analysis. Cox proportional hazard regression models were applied to examine the risk of mortality according to the PP trajectory groups.
Three PP trajectory groups were identified: slow decline (N = 96), moderate decline (N = 234) and fast decline (N = 274). After adjustments for potential confounding variables and the baseline SPPB scores, the residents in the fast decline and moderate decline trajectory groups had an increased risk of mortality compared to those in the slow decline trajectory group, with hazard ratio values of 1.78 (95% confidence interval [CI] = 1.34-2.26) and 1.37 (95% CI = 1.10-1.66), respectively.
PP trajectories provide value-added information to baseline geriatric assessments and could be used for predicting 3-year mortality among nursing home residents. It may be important to regularly monitor the SPPB score and signal an alert when a fast decline in PP is detected in older people.
先前的研究表明，老年人的身体机能（PP）会随时间发生显著变化。
确定在随访 3 年的养老院居民中，PP 轨迹及其与死亡率的关系。
为期 3 年的纵向观察研究。
SENIOR 队列的研究对象。
604 名平均年龄为 82.9±9.1 岁的养老院居民。
从病历中收集基线特征和死亡日期。PP 每年通过短体适能测试（SPPB）评估。采用多重插补处理缺失数据。采用潜在增长曲线分析估计 PP 轨迹组。应用 Cox 比例风险回归模型，根据 PP 轨迹组检查死亡率风险。
确定了 3 种 PP 轨迹组：缓慢下降组（N=96）、中度下降组（N=234）和快速下降组（N=274）。调整潜在混杂变量和基线 SPPB 评分后，与缓慢下降轨迹组相比，快速下降和中度下降轨迹组的居民死亡风险增加，危险比分别为 1.78（95%置信区间 [CI]：1.34-2.26）和 1.37（95% CI：1.10-1.66）。
PP 轨迹为基线老年评估提供了增值信息，可用于预测养老院居民 3 年死亡率。定期监测 SPPB 评分并在检测到老年人的 PP 快速下降时发出警报可能很重要。
