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一种新的日常生活活动量表预测社区居住的日本老年成年人发生功能残疾的发生率的预测效力:一项前瞻性队列研究。

Predictive Validity of a New Instrumental Activities of Daily Living Scale for Detecting the Incidence of Functional Disability among Community-Dwelling Older Japanese Adults: A Prospective Cohort Study.

机构信息

Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.

出版信息

Int J Environ Res Public Health. 2020 Mar 29;17(7):2291. doi: 10.3390/ijerph17072291.

Abstract

We examined the predictive validity of a newly developed scale-the National Center for Geriatrics and Gerontology Activities of Daily Living (NCGG-ADL)-to measure instrumental activities of daily living (IADL) ability. We tested the scale for detecting new incidences of functional disability among community-dwelling older Japanese adults. Participants were 2708 older adults (mean age = 79.0 years, 51.6% women) living in the community who had no functional decline at baseline. We assessed IADL ability using the NCGG-ADL scale, comprising 13 self-report questions. Next, we assessed their functional disability monthly for 24 months, based on the national long-term care insurance (LTCI) system. Among all participants, 430 (15.9%) had an IADL limitation at baseline, and 289 (10.7%) were newly certified as functionally disabled. Participants scoring ≤ 12 of 13 points in the NCGG-ADL showed a significantly higher risk of functional disability than did those scoring 13 points, even after adjusting for covariates (hazard ratio [95% confidence interval] = 1.58 [1.19-2.09]). We thus validated the NCGG-ADL as a screening tool for assessing the risk of functional disability among community-dwelling older Japanese adults. We conclude that IADL limitations, as measured by the NCGG-ADL, could be useful predictors of functional disability.

摘要

我们考察了新开发的国立老年医学研究中心日常生活活动量表(NCGG-ADL)预测工具测量工具性日常生活活动能力(IADL)的能力。我们用该量表检测了社区居住的日本老年人新发功能障碍的发生率。参与者为 2708 名社区居住的老年人(平均年龄 79.0 岁,51.6%为女性),基线时无功能下降。我们使用 NCGG-ADL 量表评估 IADL 能力,该量表由 13 个自我报告问题组成。然后,我们根据国家长期护理保险(LTCI)系统,每月评估他们 24 个月的功能障碍情况。在所有参与者中,430 人(15.9%)在基线时存在 IADL 受限,289 人(10.7%)新被认定为功能障碍。在 NCGG-ADL 中得分≤12 分的参与者发生功能障碍的风险显著高于得分 13 分的参与者,即使在调整了协变量后也是如此(风险比[95%置信区间] = 1.58 [1.19-2.09])。因此,我们验证了 NCGG-ADL 作为评估社区居住的日本老年人功能障碍风险的筛查工具的有效性。我们得出结论,NCGG-ADL 测量的 IADL 限制可能是功能障碍的有用预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9953/7177260/05c3ad406723/ijerph-17-02291-g001.jpg

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