按性别划分的与老年人功能能力下降相关的居住安排的关系：一项纵向观察研究。
Relationship of living arrangement with the decline in functional capacity in elderly people by gender: a longitudinal observational study.
机构信息
Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan.
Graduate School of Media and Governance, Keio University, Kanagawa, Japan.
出版信息
Environ Health Prev Med. 2020 May 20;25(1):15. doi: 10.1186/s12199-020-00853-w.
BACKGROUND
The living arrangement has been suggested as an important factor affecting health. Recent studies have also suggested that there was a risk among elderly persons who were not alone. This study examined whether the detailed living arrangement was associated with a future decline in functional capacity in the elderly, by gender, in a Japanese suburban city.
METHODS
A 3-year longitudinal questionnaire survey (baseline: 2011; follow-up: 2014) for aged 65 years or older was conducted in Kurihara city, Japan. Of the respondents in the baseline survey, we analyzed those who scored 13 points (a perfect score which indicates the highest functional capacity; n = 2627) on the Tokyo Metropolitan Institute of Gerontology Index of Competence at the baseline. The exposure was living arrangement at baseline, divided into five categories: "with spouse only," "living alone," "with child and his/her spouse," "with child without his/her spouse," and "with other family/person." The outcome was the decline in functional capacity at the follow-up survey (score decreased to 10 points or less from 13 points).
RESULTS
Of the 2627 analyzed population, 1199 (45.6%) were men. The incidence of the decline was 5.8% in men and 5.9% in women. Multivariable logistic regression analyses adjusted for age, educational attainment, and health behavior and condition revealed that in women, the odds ratio of the decline was higher in living with child and his/her spouse (2.41, 95% confidence interval; 1.10-5.28) referring to living with spouse only. When adjusting activities inside and outside the home such as housework additionally, the association was attenuated to marginal significance (2.25, 0.98-5.18). No statistical significance was observed in men.
CONCLUSIONS
These results suggested that living with child and spouse of a child was associated with the future decline in women's functional capacity.
背景
居住安排被认为是影响健康的一个重要因素。最近的研究还表明，独居的老年人存在风险。本研究在日本一个郊区城市，按性别研究了详细的居住安排是否与老年人未来的功能能力下降有关。
方法
在日本久里滨市进行了一项为期 3 年的纵向问卷调查（基线：2011 年；随访：2014 年），对象为 65 岁或以上的老年人。在基线调查中，我们分析了那些在基线时东京都老人研究所能力指数得分为 13 分（功能能力最高的满分；n=2627）的受访者。暴露因素为基线时的居住安排，分为五类：“仅与配偶同住”、“独居”、“与子女及其配偶同住”、“与子女但无配偶同住”和“与其他家庭/人同住”。结局为随访调查时的功能能力下降（从 13 分降至 10 分或更低）。
结果
在分析的 2627 名人群中，1199 名（45.6%）为男性。男性的下降发生率为 5.8%，女性为 5.9%。多变量逻辑回归分析调整了年龄、教育程度、健康行为和状况后显示，在女性中，与仅与配偶同住相比，与子女及其配偶同住的下降几率更高（2.41，95%置信区间；1.10-5.28）。当调整家务等家庭内外活动时，相关性减弱至边缘显著（2.25，0.98-5.18）。在男性中未观察到统计学意义。
结论
这些结果表明，与子女及其配偶同住与女性未来的功能能力下降有关。
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