Beard John R, Si Yafei, Liu Zhixin, Chenoweth Lynn, Hanewald Katja
ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, Australia.
School of Risk and Actuarial Studies, University of New South Wales, Sydney, Australia.
J Gerontol A Biol Sci Med Sci. 2022 Jan 7;77(1):94-100. doi: 10.1093/gerona/glab226.
BACKGROUND: The World Health Organization has proposed a model of healthy aging built around the concept of functional ability, comprising an individual's intrinsic capacity, the physical and social environment they occupy, and interactions between the two. However, these constructs have been poorly defined. We examined the structure of intrinsic capacity in a representative sample of the Chinese population aged 60 years and older and assessed its value in predicting declining performance in instrumental activities of daily living (IADLs) and activities of daily living (ADLs) using similar methods to a construct validation previously undertaken in an English cohort. METHODS: Deidentified data were accessed on 7 643 participants of the China Health and Retirement Longitudinal Study 2011 and 2013 waves. Incrementally related structural equation modeling was applied, including exploratory and confirmatory factor analysis, and path analysis. Multiple linear regression tested construct validity, and simple and serial mediation models assessed predictive validity. RESULTS: Factor loadings for the models showed a clear structure for intrinsic capacity: 1 general factor with 5 subfactors-locomotor, cognitive, psychological and sensory capacities, and vitality (reflecting underlying physiologic changes). Intrinsic capacity predicted declining performance in both IADLs (standardized coefficient (SE) -0.324 (0.02), p < .001) and ADLs (-0.227 (0.03), p < .001), after accounting for age, sex, education, wealth, and number of chronic diseases. Each characteristic was associated with intrinsic capacity, providing strong construct validity. CONCLUSIONS: Assessment of intrinsic capacity provides valuable information on an individual's subsequent functioning beyond that afforded by age, other personal factors, and multimorbidity.
背景:世界卫生组织提出了一个围绕功能能力概念构建的健康老龄化模型,该模型包括个体的内在能力、他们所处的物理和社会环境以及两者之间的相互作用。然而,这些概念的定义并不明确。我们在中国60岁及以上人群的代表性样本中研究了内在能力的结构,并使用与之前在一个英国队列中进行的结构验证类似的方法,评估了其在预测日常生活工具性活动(IADL)和日常生活活动(ADL)能力下降方面的价值。 方法:获取了中国健康与养老追踪调查2011年和2013年两轮调查中7643名参与者的匿名数据。应用逐步相关结构方程模型,包括探索性和验证性因子分析以及路径分析。多元线性回归检验结构效度,简单和系列中介模型评估预测效度。 结果:模型的因子载荷显示了内在能力的清晰结构:1个一般因子和5个子因子——运动能力、认知能力、心理和感官能力以及活力(反映潜在的生理变化)。在考虑年龄、性别、教育程度、财富和慢性病数量后,内在能力预测了IADL(标准化系数(SE)-0.324(0.02),p <.001)和ADL(-0.227(0.03),p <.001)能力的下降。每个特征都与内在能力相关,提供了很强的结构效度。 结论:内在能力评估提供了有关个体后续功能的有价值信息,这些信息超出了年龄、其他个人因素和多种疾病所提供的信息。
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