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伴侣丧失及其对虚弱轨迹的影响:来自欧洲健康、老龄化和退休研究 13 年随访调查(SHARE)的结果。

Partner loss and its effect on frailty trajectories: results from the 13-year follow-up Survey of Health, Ageing and Retirement in Europe (SHARE).

机构信息

Department of Social and Preventive Medicine, Medical University of Vienna, Center for Public Health, Vienna, Austria

Department of Sport Science, University of Vienna, Vienna, Austria.

出版信息

J Epidemiol Community Health. 2022 Mar;76(3):209-215. doi: 10.1136/jech-2021-216637. Epub 2021 Aug 27.

Abstract

BACKGROUND

Frailty is a geriatric syndrome closely linked to a variety of adverse health outcomes. Thus, it is important to identify factors associated with the development of frailty. It was the aim of this study to examine, if, and to what extent partner loss, a highly stressful life event, affects frailty trajectories of community dwelling adults aged 50 or older.

METHODS

Using six waves of panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigated the effect of partner loss on frailty trajectories estimating growth curve models. Our sample included 183 502 observations of 83 494 community-dwelling individuals aged 50 or older from 21 European countries collected between 2004 and 2017. Frailty was measured using the validated sex-specific SHARE-Frailty-Instrument including muscular weakness, unintended weight loss, decrease in walking capacity, low physical activity and exhaustion.

RESULTS

Our sample contained 79 874 participants who lived in a partnership during their entire observational period and 3620 participants who lost their partner during their observational period. Both men (β=0.184 (95% CI: -0.017 to 0.386), p=0.073) and women (β=0.237 (95% CI: 0.106 to 0.369), p<0.001) showed initial effects of partner loss on frailty, but while only women gradually recovered over time (β=-0.023 (95% CI: -0.039 to -0.008), p=0.002), among men, the effect of partner loss persisted (β<0.001 (95% CI: -0.029 to 0.029), p=0.998).

CONCLUSION

This study revealed that partner loss is followed by elevated frailty. However, while women's frailty tended to recover from partner loss over time, men's frailty remained elevated. Notable individual differences in the response of frailty trajectories to partner loss suggest the existence of effect modifiers.

摘要

背景

衰弱是一种与多种不良健康结果密切相关的老年综合征。因此,识别与衰弱发展相关的因素非常重要。本研究旨在探讨配偶丧失这一高度应激性生活事件是否以及在何种程度上影响 50 岁或以上社区居住成年人的衰弱轨迹。

方法

利用欧洲健康、老龄化和退休调查(SHARE)的六轮面板数据,我们通过估计增长曲线模型,研究了配偶丧失对衰弱轨迹的影响。我们的样本包括 21 个欧洲国家的 83494 名 50 岁或以上社区居住个体的 183502 个观察值,数据收集于 2004 年至 2017 年。使用经过验证的基于性别的 SHARE-Frailty-Instrument 衡量衰弱,该工具包括肌肉无力、意外体重减轻、行走能力下降、低身体活动量和疲惫。

结果

我们的样本包含 79874 名在整个观察期内都处于伴侣关系中的参与者和 3620 名在观察期内失去伴侣的参与者。男性(β=0.184(95%CI:-0.017 至 0.386),p=0.073)和女性(β=0.237(95%CI:0.106 至 0.369),p<0.001)在配偶丧失后均表现出衰弱的初始效应,但只有女性随着时间的推移逐渐恢复(β=-0.023(95%CI:-0.039 至-0.008),p=0.002),而男性的配偶丧失效应持续存在(β<0.001(95%CI:-0.029 至 0.029),p=0.998)。

结论

本研究表明,配偶丧失后衰弱程度升高。然而,尽管女性的衰弱随着时间的推移逐渐从配偶丧失中恢复,但男性的衰弱仍然处于较高水平。衰弱轨迹对配偶丧失的反应存在显著的个体差异,这表明存在调节因素。

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