老年人的握力与自我报告的功能障碍之间的关系：自评健康的作用。

Relationship between handgrip strength and self-reported functional difficulties among older Indian adults: The role of self-rated health.

机构信息

International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.

出版信息

Exp Gerontol. 2022 Aug;165:111833. doi: 10.1016/j.exger.2022.111833. Epub 2022 May 13.

DOI:10.1016/j.exger.2022.111833

PMID:35577266

Abstract

BACKGROUND

Older individuals' handgrip strength is a predictor of functional health and their self-perceptions of health may influence functional health and disability. Hence, the study explored the associations between handgrip strength and self-reported functional difficulties in activities of daily living (ADL) and instrumental ADL (IADL) among older adults. The study also explored the moderation and mediation effects of self-rated health (SRH) in those associations.

METHODS

Data for the study were drawn from the baseline survey of Longitudinal Ageing Study in India (LASI, 2017-18). This study was conducted on respondents aged 60 years and above with a total sample of 27,707 older adults (men-13,199 and women-14,508). The study assessed handgrip strength using a handheld Smedley's Hand Dynamometer with a cut-off of 19.5 kg for males and 12.5 kg for females. Moderated multivariable regression models and the Karlson-Holm-Breen (KHB) method adjusting for many confounders, were used to explore the moderation and mediation effects of SRH in the association of handgrip strength and functional difficulties.

RESULTS

A proportion of 25.80% of men and 26.24% of women of our sample had weak grip strength. A large proportion of older persons experienced difficulty in ADL (23.77%) and IADL (48.36%) in the study. Older adults with weak handgrip strength had higher odds of suffering from functional difficulties in ADL [adjusted odds ratio (aOR): 1.34; 95% confidence interval (CI):1.14-1.57] and IADL [aOR: 1.38; 95%CI: 1.18-1.60] than older adults with strong handgrip. Older adults who had weak handgrip strength and poor SRH had higher odds of difficulty in ADL [aOR: 2.72; 95%CI: 1.61-3.22] and IADL [aOR: 1.87; CI: 1.28-2.74] compared to those with strong handgrip and good SRH. Further, the association between handgrip strength and functional health was mediated by SRH (percent effect mediated: 26% for ADL and 16.84% for IADL).

CONCLUSION

The findings provide further evidence that handgrip strength is connected with the disabling process and moderating and mediating role of SRH in these associations suggest that enhancement of self-perceptions of health among older adults may help prevent ADL and IADL-related issues in the later phase of life.

摘要

背景

老年人的握力是其身体健康的预测指标，而他们对健康的自我感知可能会影响其身体健康和残疾状况。因此，本研究探讨了老年人握力与自我报告的日常生活活动（ADL）和工具性日常生活活动（IADL）功能困难之间的关系。本研究还探讨了自我评估健康（SRH）在这些关联中的调节和中介作用。

方法

本研究的数据来自印度纵向老龄化研究（LASI，2017-18 年）的基线调查。本研究对象为年龄在 60 岁及以上的受访者，总样本量为 27707 名老年人（男性 13199 人，女性 14508 人）。研究使用手持式 Smedley 握力计评估握力，男性的截断值为 19.5 公斤，女性为 12.5 公斤。使用调节多元回归模型和卡尔森-霍尔姆-布林（KHB）方法调整了许多混杂因素，以探讨 SRH 在握力与功能困难之间的关联中的调节和中介作用。

结果

在我们的样本中，有 25.80%的男性和 26.24%的女性握力较弱。研究中，很大一部分老年人在 ADL（23.77%）和 IADL（48.36%）方面存在困难。握力较弱的老年人在 ADL（调整后的优势比（aOR）：1.34；95%置信区间（CI）：1.14-1.57）和 IADL（aOR：1.38；95%CI：1.18-1.60）方面出现功能困难的可能性高于握力较强的老年人。握力较弱且自我评估健康状况较差的老年人在 ADL（调整后的优势比（aOR）：2.72；95%置信区间（CI）：1.61-3.22）和 IADL（调整后的优势比（aOR）：1.87；95%CI：1.28-2.74）方面出现困难的可能性高于握力较强且自我评估健康状况较好的老年人。此外，SRH 介导了握力与身体健康之间的关联（ADL 的中介效应百分比为 26%，IADL 的中介效应百分比为 16.84%）。