12330The University of Texas at Austin, Austin, TX, USA.
5170University of Louisville, Louisville, USA.
J Aging Health. 2022 Mar;34(2):196-205. doi: 10.1177/08982643211037512. Epub 2021 Aug 13.
ObjectivesMexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010-2011, 2012-2013, and 2016, = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.
目的
墨西哥裔美国人的平均寿命比其他族裔长，但他们往往长期存在认知和身体残疾。然而，对于认知能力下降在日常生活活动工具性（IADL）残疾中的作用，以及对最年长的老年人（80 岁以上）的 IADL 残疾的次要结果，人们知之甚少。我们使用西班牙裔老年人流行病学研究的既定人群（2010-2011 年、2012-2013 年和 2016 年，=1078），使用潜在转变分析来研究 IADL 下降的纵向模式。确定了三个 IADL 组：独立（发展中的行动限制）、新兴依赖（有限的行动能力和社区活动）和依赖（有限的行动能力和家庭和社区活动）。认知功能的下降是 IADL 残疾程度更大的一致预测因素，孤独感是新兴依赖的一个特别突出的远端结果。这些结果突出了认知能力下降和依赖的社会后果，并强调了残疾过程每个阶段干预的重要领域。
