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体力不足而非抑郁和认知障碍对百岁老人预后有负面影响:一项具有 5 年随访的前瞻性研究。

Physical inability rather than depression and cognitive impairment had negative effect on centenarian prognosis: A prospective study with 5-year follow-up.

机构信息

Department of Anesthesiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.

Department of Critical Care, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.

出版信息

J Affect Disord. 2023 Oct 1;338:299-304. doi: 10.1016/j.jad.2023.05.072. Epub 2023 May 25.

Abstract

AIM

Scarce study has involved the effects of physical inability, depression and cognitive impairment on the prognosis of older individuals, especially in Chinese centenarians. This prospective study was designed to investigate the effects with 5-year follow-up in Chinese centenarians.

METHODS

According to the list of centenarians provided by Department of Civil Affairs, an household survey was conducted on all centenarians residing in 18 cities and counties of Hainan province. A total of 423 centenarians were followed up, including 84 survival centenarians and 261 dead centenarians, with 78 cases lost to follow-up.

RESULTS

Dead centenarians had less females and more physical inability than survival centenarians (P < 0.05 for all). Univariable Cox regression analyses indicated that physical inability [EXP(B): 2.038, 95 % confidence interval (CI): 1.413-2.939], urea nitrogen [EXP(B): 1.116, 95 % CI: 1.039-1.199], and creatinine [EXP(B): 1.006, 95 % CI: 1.001-1.012] had negative effects on the prognosis of centenarians (all P < 0.05). Gender [EXP(B): 0.606, 95 % CI: 0.391-1.940] and albumin [EXP(B): 0.939, 95 % CI: 0.896-0.985] had positive effects on the prognosis of centenarians (all P < 0.05). Multivariable Cox regression analysis indicated that physical inability [EXP(B): 2.148, 95 % CI: 1.454-3.173] and urea nitrogen [EXP(B): 1.114, 95 % CI: 1.020-1.216] had negative effects on the prognosis of centenarians (all P < 0.05).

CONCLUSIONS

For Chinese centenarians, this prospective study demonstrated that physical inability rather than depression and cognitive impairment had negative effect on the long-term mortality rate and survival time. This result suggested that in order to improve the prognosis of older adults, it could be mainly achieved by improving physical ability.

摘要

目的

鲜有研究涉及身体失能、抑郁和认知障碍对老年人预后的影响,尤其是对中国百岁老人。本前瞻性研究旨在探讨 5 年随访中中国百岁老人的影响。

方法

根据民政部门提供的百岁老人名单,对海南省 18 个市县的所有百岁老人进行了入户调查。共随访 423 名百岁老人,其中 84 名存活百岁老人和 261 名死亡百岁老人,78 名失访。

结果

死亡的百岁老人女性比例较低,身体失能比例较高(均 P<0.05)。单变量 Cox 回归分析表明,身体失能[EXP(B):2.038,95%置信区间(CI):1.413-2.939]、尿素氮[EXP(B):1.116,95%CI:1.039-1.199]和肌酐[EXP(B):1.006,95%CI:1.001-1.012]对百岁老人的预后有负面影响(均 P<0.05)。性别[EXP(B):0.606,95%CI:0.391-1.940]和白蛋白[EXP(B):0.939,95%CI:0.896-0.985]对百岁老人的预后有积极影响(均 P<0.05)。多变量 Cox 回归分析表明,身体失能[EXP(B):2.148,95%CI:1.454-3.173]和尿素氮[EXP(B):1.114,95%CI:1.020-1.216]对百岁老人的预后有负面影响(均 P<0.05)。

结论

对于中国的百岁老人,本前瞻性研究表明,身体失能而非抑郁和认知障碍对长期死亡率和生存时间有负面影响。这一结果表明,为了改善老年人的预后,可以主要通过提高身体能力来实现。

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