Hajek André, Brettschneider Christian, Eisele Marion, Mallon Tina, Oey Anke, Wiese Birgitt, Weyerer Siegfried, Werle Jochen, Fuchs Angela, Pentzek Michael, Gühne Uta, Röhr Susanne, Weeg Dagmar, Bickel Horst, Kleineidam Luca, Wagner Michael, Scherer Martin, Maier Wolfgang, Riedel-Heller Steffi G, König Hans-Helmut
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Gerontology. 2022;68(2):200-208. doi: 10.1159/000516077. Epub 2021 May 12.
Longitudinal studies investigating the link between social support and functional decline are limited among the oldest old. Thus, the aim of this study was to examine whether changes in social support are associated with functional decline among the oldest old longitudinally using panel regression models.
Longitudinal data from 3 waves (waves 7, 8, and 9) of a multicenter prospective cohort study covering primary care patients aged ≥85 years were used. In the analytical sample, n equaled 624 individuals. The validated Lawton and Brody Instrumental Activities of Daily Living (IADL) scale and the well-established Barthel Index (ADL) were used to quantify functional status. The psychometrically sound Lubben Social Network Scale was used to measure social support. Several potential confounders such as age, marital status, cognitive decline, or depressive symptoms were included in the fixed effects (FE) regression models.
Linear FE regressions showed that a decrease in social support is associated with functional decline (IADL: β = 0.03, p < 0.05; ADL: β = 0.27, p < 0.05) in men but not in women. With IADL as outcome measure, the interaction term (sex × social support) achieved statistical significance (p < 0.01). With regard to covariates, functional decline (IADL and ADL) was consistently associated with increasing age, an increase in the number of chronic conditions (except for women [ADL]), and cognitive decline (except for men [ADL]). Furthermore, functional decline (ADL) was associated with an increase in depressive symptoms.
Our findings highlight the meaning of social support for functional status among the oldest old. Finding ways to sustain social support in highest age may be a promising approach in order to postpone functional decline.
在高龄老人中，探究社会支持与功能衰退之间联系的纵向研究有限。因此，本研究的目的是使用面板回归模型纵向检验社会支持的变化是否与高龄老人的功能衰退相关。
使用来自一项多中心前瞻性队列研究3个波次（第7、8和9波次）的纵向数据，该研究涵盖年龄≥85岁的初级保健患者。在分析样本中，n等于624人。使用经过验证的劳顿和布罗迪日常生活活动能力（IADL）量表以及成熟的巴氏指数（ADL）来量化功能状态。使用心理测量可靠的鲁本社会网络量表来衡量社会支持。固定效应（FE）回归模型纳入了几个潜在的混杂因素，如年龄、婚姻状况、认知衰退或抑郁症状。
线性FE回归显示，社会支持的减少与男性的功能衰退相关（IADL：β = 0.03，p < 0.05；ADL：β = 0.27，p < 0.05），但与女性无关。以IADL作为结果指标时，交互项（性别×社会支持）具有统计学意义（p < 0.01）。关于协变量，功能衰退（IADL和ADL）始终与年龄增长、慢性病数量增加（女性[ADL]除外）以及认知衰退（男性[ADL]除外）相关。此外，功能衰退（ADL）与抑郁症状的增加相关。
我们的研究结果凸显了社会支持对高龄老人功能状态的意义。寻找在最高龄阶段维持社会支持的方法可能是延缓功能衰退的一种有前景的途径。
