National University of Singapore, 469C Bukit Timah Road, Singapore, 259772, Singapore.
Arch Gerontol Geriatr. 2020 Sep-Oct;90:104169. doi: 10.1016/j.archger.2020.104169. Epub 2020 Jun 30.
The aims of this study were to examine the incidence of activities of daily living (ADL) and instrumental activities of daily living (IADL) disability in a national sample of community-living older adults, and to evaluate the value of baseline self-rated health (SRH) in predicting these outcomes. Additionally, we investigated whether SRH's prognostic ability extended to individual ADL/IADL components (e.g. bathing, managing money).
Data were obtained from the 2014 and 2016 Korean Longitudinal Study of Aging (N = 3431). Respondents were aged 65+ and non-disabled at baseline. Setting the respondents with "very good" or "good" baseline SRH as the reference group, logistic regression models were applied to analyze the association between SRH and disability risk.
The overall incidence rates for ADL and IADL were 25.6 and 53.4/1000 person-years, respectively. Disability incidence increased significantly with poorer SRH. In multivariable regressions, subsequent 1 + ADL disability was significantly associated with "bad" (OR 2.86) and "very bad" SRH (OR 4.28). SRH also predicted 1 + IADL disability for respondents who reported "moderate", "bad", or "very bad" health (OR 2.01-3.39). SRH was predictive of three out of five ADL components, and seven out of 10 IADL components.
SRH predicted functional decline after two years in older adults without baseline disabilities, and its prognostic ability extended to individual ADL/IADL components. Patterns of SRH-morbidity associations can help health administrators identify those at risk of subsequent functional decline. Early interventions targeted at those with poor SRH can help alleviate the strain on long-term care support systems.
本研究旨在调查日常生活活动（ADL）和工具性日常生活活动（IADL）残疾在全国社区居住的老年人样本中的发生率，并评估基线自我报告健康（SRH）在预测这些结果中的价值。此外，我们还研究了 SRH 的预后能力是否扩展到个体 ADL/IADL 组成部分（例如洗澡、管理金钱）。
数据来自 2014 年和 2016 年韩国老龄化纵向研究（N=3431）。受访者年龄在 65 岁及以上，基线时无残疾。将基线 SRH“非常好”或“好”的受访者设定为参考组，应用逻辑回归模型分析 SRH 与残疾风险的关系。
ADL 和 IADL 的总发生率分别为 25.6/1000人年和 53.4/1000人年。残疾发生率随 SRH 变差而显著增加。在多变量回归中，随后发生的 1+ADL 残疾与“差”（OR=2.86）和“非常差”（OR=4.28）的 SRH 显著相关。对于报告“中等”、“差”或“非常差”健康的受访者，SRH 也预测了 1+IADL 残疾（OR=2.01-3.39）。SRH 可预测五个 ADL 组成部分中的三个，十个 IADL 组成部分中的七个。
在没有基线残疾的老年人中，SRH 预测了两年后的功能下降，其预后能力扩展到个体的 ADL/IADL 组成部分。SRH-发病关联模式有助于卫生管理人员识别那些有后续功能下降风险的人。针对 SRH 较差者的早期干预可以帮助减轻长期护理支持系统的负担。
