美国医疗保险受益人群中有无癌症史者的移动设备使用情况和移动障碍
Mobility Device Use and Mobility Disability in U.S. Medicare Beneficiaries With and Without Cancer History.
机构信息
Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
J Am Geriatr Soc. 2020 Dec;68(12):2872-2880. doi: 10.1111/jgs.16789. Epub 2020 Sep 24.
BACKGROUND/OBJECTIVES: To examine the prevalence of mobility device use in U.S. community-dwelling older adults including older adults with cancer history ("survivors") and to estimate mobility disability noting variation by cancer history, cancer site, and other factors to improve early detection of mobility limitations.
DESIGN
Cross-sectional analysis from the 2011 National Health and Aging Trends Study.
SETTING
In-person interviews in the homes of study participants.
PARTICIPANTS
Nationally representative sample of community-dwelling Medicare beneficiaries, aged 65 and older (n = 6,080 including 1,203 survivors).
MEASUREMENTS
Participants were asked about cancer history, pain that limited activity, mobility device use (eg, canes, walkers, wheelchairs, and scooters), history of falls, and medical conditions plus they were assessed for approximate mobility disability using a 3-m gait speed test. The results were scored on a scale of 0 to 4 (0 = lowest, 4 = highest) using criteria from the National Institute on Aging.
RESULTS
A total of 19% of older adults and 23% of survivors reported using one or more mobility device, most commonly a single-point cane. Approximately 10% of breast, 6% of prostate, and 3% of colorectal cancer survivors reported using two or more devices in the past month. Survivors had lower mean gait speed scores (2.27) than adults without cancer history (2.39). In regression models, survivors were 18% less likely than adults without cancer history to score high on the gait speed test (odds ratio = .82; P < .05). Prior mobility device use, history of multiple falls, unhealthy weight, Black race, multimorbidity, and pain that limited activity were associated with lower gait speed scores in all participants (all P < .05).
CONCLUSION
A greater proportion of older survivors used mobility devices than adults without cancer history. Mobility device use varied by cancer site and was highest in survivors of breast, colorectal, and gynecological cancer. Survivors were also more likely to show signs of mobility disability, based on gait speed, compared with adults without cancer history. These indications, although modest, suggest that older survivors may require special attention to functional changes in survivorship.
背景/目的:检查美国社区居住的老年人(包括有癌症病史的老年人)使用移动设备的流行情况,评估移动障碍,注意根据癌症病史、癌症部位和其他因素的变化,以提高对移动受限的早期检测。
设计
来自 2011 年国家健康与老龄化趋势研究的横断面分析。
地点
研究参与者家中的面对面访谈。
参与者
全国代表性的社区居住的医疗保险受益人样本,年龄在 65 岁及以上(包括 1203 名幸存者,共 6080 人)。
测量
询问参与者有关癌症病史、限制活动的疼痛、移动设备使用情况(如拐杖、助行器、轮椅和踏板车)、跌倒史和医疗状况,以及使用 3 米步行速度测试评估近似移动障碍。结果根据国家老龄化研究所的标准,使用 0 到 4 分(0 为最低,4 为最高)的评分进行评分。
结果
19%的老年人和 23%的幸存者报告使用一种或多种移动设备,最常见的是单点拐杖。大约 10%的乳腺癌、6%的前列腺癌和 3%的结直肠癌幸存者报告在过去一个月内使用了两种或两种以上的设备。与没有癌症病史的成年人相比,幸存者的平均步行速度评分(2.27)较低。在回归模型中,与没有癌症病史的成年人相比,幸存者在步态速度测试中获得高分的可能性低 18%(优势比=0.82;P<0.05)。既往使用移动设备、多次跌倒史、体重不健康、黑人种族、多病和限制活动的疼痛与所有参与者的较低步行速度评分相关(所有 P<0.05)。
结论
与没有癌症病史的成年人相比,更多的老年幸存者使用移动设备。癌症部位不同,移动设备的使用情况也不同,乳腺癌、结直肠癌和妇科癌症的幸存者使用情况最高。与没有癌症病史的成年人相比,幸存者的移动障碍迹象(基于步行速度)也更有可能出现。这些迹象虽然不大,但表明老年幸存者可能需要特别注意生存后的功能变化。
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