横断面研究调查中国社区居住的老年人内在能力下降的状况：患病率、相关因素及其对临床护理的意义。

Cross-sectional study examining the status of intrinsic capacity decline in community-dwelling older adults in China: prevalence, associated factors and implications for clinical care.

机构信息

Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Disorders, Beijing, China

Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Disorders, Beijing, China.

出版信息

BMJ Open. 2021 Jan 5;11(1):e043062. doi: 10.1136/bmjopen-2020-043062.

DOI:10.1136/bmjopen-2020-043062

PMID:33402410

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7786809/

Abstract

OBJECTIVES

Intrinsic capacity (IC) was proposed by the WHO as a new concept for capturing an individual's functional capacities across their lifetime. We aimed to investigate the prevalence and factors associated with IC decline and examine associations between IC and adverse outcomes among community-dwelling older adults in China.

DESIGN

A cross-sectional study.

SETTING

Community, China.

PARTICIPANTS

Data were derived from the China Comprehensive Geriatric Assessment Study, a population-based nationally representative sample. IC comprises of five domains: locomotion, cognition, vitality, sensory and psychology. Participants were deemed to have IC decline if they showed a decline in any of the five domains. Sociodemographic characteristics, chronic diseases, geriatric syndromes and adverse outcomes were also examined.

RESULTS

Of the 5823 community-dwelling participants aged 60-98 years, 2506 had IC decline (weighted 39.9%): 57.7% in western, 38.3% in northern, 33.7% in northwest, 36.1% in middle, 16.9% in eastern and 19.8% in northeast China. The number of participants with decline in the locomotion, cognition, vitality, sensory and psychological domains were 1039 (17.8%), 646 (11.1%), 735 (12.6%), 824 (14.2%) and 713 (12.2%), respectively. Age, northern residence, low education, being unmarried, low income, less exercise, less meat intake, insomnia, memory loss, urinary incontinence, constipation, slowness, chronic obstructive pulmonary disease and osteoarthritis were related to IC decline. After adjusting for age, sex, area, district, marriage, education, waist-hip ratio, smoking, alcohol consumption, exercise, income and chronic diseases, IC decline was independently associated with risk of frailty, disability, falls, fractures and immobility.

CONCLUSION

The prevalence of IC decline in China is high. IC decline was significantly associated with adverse outcomes, after adjustment for related variables. Efforts promoting IC to delay functional dependence should focus on modifiable factors, including negative social factors, poor lifestyle, chronic diseases and geriatric syndromes.

摘要

目的

世界卫生组织（WHO）提出内在能力（IC）的新概念，以捕捉个体一生的功能能力。我们旨在研究中国社区老年人 IC 下降的患病率和相关因素，并检查 IC 与不良结局之间的关系。

设计

横断面研究。

地点

社区，中国。

参与者

数据来自中国综合老年评估研究，这是一个基于人群的全国代表性样本。IC 由五个领域组成：运动、认知、活力、感觉和心理。如果参与者在五个领域中的任何一个领域表现出下降，则认为他们的 IC 下降。还检查了社会人口特征、慢性疾病、老年综合征和不良结局。

结果

在 5823 名 60-98 岁的社区居住参与者中，有 2506 人（加权 39.9%）出现 IC 下降：西方 57.7%，北方 38.3%，西北 33.7%，中部 36.1%，东部 16.9%，东北 19.8%。运动、认知、活力、感觉和心理领域下降的参与者人数分别为 1039 人（17.8%）、646 人（11.1%）、735 人（12.6%）、824 人（14.2%）和 713 人（12.2%）。年龄、北方居住、低教育程度、未婚、低收入、运动少、肉类摄入少、失眠、记忆力减退、尿失禁、便秘、动作缓慢、慢性阻塞性肺疾病和骨关节炎与 IC 下降有关。在调整年龄、性别、地区、区、婚姻、教育、腰臀比、吸烟、饮酒、运动、收入和慢性疾病后，IC 下降与衰弱、残疾、跌倒、骨折和活动受限的风险独立相关。