Laddu Deepika R, Saquib Nazmus, Manson JoAnn E, Arena Ross, Shadyab Aladdin H, Weitlauf Julie C, Hovey Kathleen M, Andrews Christopher, Banack Hailey, Stefanick Marcia L, LaMonte Michael J
From the Department of Physical Therapy, College of Applied Health Sciences, University of Illinois-Chicago, Chicago, IL.
Department of Research, College of Medicine, Sulaiman AlRajhi University, Kingdom of Saudi Arabia.
Menopause. 2022 Jul 1;29(7):823-831. doi: 10.1097/GME.0000000000001982.
Research is limited regarding the predictive utility of the RAND-36 questionnaire and physical performance tests in relation to all-cause, cardiovascular disease (CVD), and total-cancer mortality in older women.
Data on the RAND-36 questionnaire, gait speed, and chair stand performance were assessed in 5,534 women aged ≥65 years at baseline. A subset (n = 298) had physical function assessments additionally at follow-up (years 1, 3, or 6). Multivariable Cox proportional hazards regression models estimated associations (HR) for a 1-standard deviation (SD) difference in baseline RAND-36 scores and performance tests (alone and combined) with mortality outcomes in the overall cohort and in models stratified by enrollment age (<70 and ≥ 70 y). The relative prognostic value of each physical function exposure was assessed using the Uno concordance statistic.
A total of 1,186 deaths from any cause, 402 deaths from CVD, and 382 deaths from total-cancer were identified during a mean follow-up of 12.6 years. Overall, each 1-SD unit higher baseline RAND-36 score was associated with significantly lower all-cause mortality (HR =0.90) and discriminatory capacity (Uno = 0.65) that was comparable to each performance exposure (HRs 0.88-0.91; Uno = 0.65). These findings were consistent in women aged <70 and ≥ 70 years. The associations of RAND-36 and performance measures with CVD mortality and total-cancer mortality were not significant in multivariable models nor in age-stratified models.
The RAND-36 questionnaire is a reasonable substitute for tracking physical functioning and estimating its association with all-cause mortality in older adults when clinical performance testing is not feasible.
关于兰德36项问卷和身体机能测试对老年女性全因死亡率、心血管疾病（CVD）死亡率和全癌死亡率的预测效用，相关研究有限。
对5534名年龄≥65岁的女性进行基线时的兰德36项问卷、步速和从椅子上站起能力的评估。其中一个亚组（n = 298）在随访（第1年、第3年或第6年）时还进行了身体功能评估。多变量Cox比例风险回归模型估计了基线兰德36项评分和身体机能测试（单独及联合）1个标准差（SD）差异与总体队列以及按入组年龄（<70岁和≥70岁）分层的模型中死亡率结局之间的关联（HR）。使用Uno一致性统计量评估每种身体功能暴露的相对预后价值。
在平均12.6年的随访期间，共确定了1186例全因死亡、402例CVD死亡和382例全癌死亡。总体而言，基线兰德36项评分每高出1个SD单位，与显著更低的全因死亡率（HR = 0.90）和鉴别能力（Uno = 0.65）相关，这与每种身体机能暴露相当（HR为0.88 - 0.91；Uno = 0.65）。这些结果在<70岁和≥70岁的女性中是一致的。在多变量模型和年龄分层模型中，兰德36项评分及身体机能指标与CVD死亡率和全癌死亡率之间的关联均不显著。
当临床身体机能测试不可行时，兰德36项问卷是追踪老年人身体功能并估计其与全因死亡率关联的合理替代方法。
