Díaz-Venegas Carlos, Wong Rebeca
Monterrey, NL, Mexico.
Senior Fellow, Sealy Center on Aging; Director, WHO/PAHO Collaborating Center on Aging and Health, The University of Texas Medical Branch, United States.
Arch Gerontol Geriatr. 2020 Nov/Dec;91:104208. doi: 10.1016/j.archger.2020.104208. Epub 2020 Jul 26.
This paper examines the key determinants of the likelihood of recovery from a physical disability among older adults.
Data come from the Mexican Health and Aging Study (MHAS), a national sample of adults born in 1951 or earlier, including a baseline survey in 2001 and follow-ups in 2003, 2012 and 2015. At baseline, we divided our sample of older adults aged 60+ by dimensions of physical limitations (ADLs, IADLs, mobility) and classified respondents as having physical limitations in zero, one, two or three dimensions. Each respondent was then categorized as "same", "worse", "improved" or "died" depending on the number of physical dimensions with a limitation in a 2-year span (2001-2003) and again, separately, in a 3-year span (2012-2015). We then used a multinomial logistic regression to analyze the relative risk of transitioning from one category to another.
Around 21 % of our sample exhibited some recovery in 2003 and around 20 % recovered in 2015. Age, gender, poor self-rated health, depression and some chronic conditions were significant for shifting the relative risk from staying the same to getting worse, dying or even improving.
Disability from a physical limitation is a reversible and dynamic process. Our results reflect the importance of considering the dimensions of physical ability while analyzing recovery, and illustrate that the presence of a chronic condition or depressive symptoms does not necessarily imply permanent disability.
本文探讨了老年人身体残疾恢复可能性的关键决定因素。
数据来自墨西哥健康与老龄化研究（MHAS），该研究是对1951年或更早出生的成年人的全国性抽样调查，包括2001年的基线调查以及2003年、2012年和2015年的随访。在基线时，我们根据身体限制的维度（日常生活活动能力、工具性日常生活活动能力、行动能力）将60岁及以上的老年人样本进行划分，并将受访者分为在零个、一个、两个或三个维度上存在身体限制。然后，根据2年时间段（2001 - 2003年）以及另外单独的3年时间段（2012 - 2015年）内存在限制的身体维度数量，将每位受访者分类为“相同”“更差”“改善”或“死亡”。接着，我们使用多项逻辑回归分析从一个类别转变为另一个类别的相对风险。
在我们的样本中，约21%的人在2003年表现出一定程度的恢复，约20%的人在2015年恢复。年龄、性别、自评健康状况差、抑郁和一些慢性疾病对于将相对风险从保持不变转变为恶化、死亡甚至改善具有显著影响。
身体限制导致的残疾是一个可逆的动态过程。我们的结果反映了在分析恢复情况时考虑身体能力维度的重要性，并表明慢性病或抑郁症状的存在不一定意味着永久性残疾。
