Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China.
Ageing Res Rev. 2024 Mar;95:102239. doi: 10.1016/j.arr.2024.102239. Epub 2024 Feb 19.
BACKGROUND: The World Health Organization defined healthy ageing as the maintenance of functional ability with ageing. Intrinsic capacity is a measurement of healthy ageing, and can be shaped by social determinants. However, an overall understanding of how multiple social determinants contribute to intrinsic capacity remains unclear. We aim to summarize observational studies investigating the relationships between social determinants and intrinsic capacity among community-dwelling adults. METHODS: A systematic search was conducted through Medline, Embase, PsycInfo, Web of Science, and CINAHL until August 14, 2023. RESULTS: After reviewing 813 articles, we included 21 studies from nine countries in Asia, Europe, and America. Seventeen studies used a cross-sectional design and the others were longitudinal studies. Social determinants related to intrinsic capacity can be classified into five domains, containing socioeconomic status (16, 76.2% of studies), lifestyles (14, 66.7%), psychosocial factors (9, 42.9%), material circumstances (4, 19.0%), and healthcare systems (1, 4.8%). Strong evidence supported that better intrinsic capacity was associated with higher education, higher wealth, more physical activities, no smoking, more social engagement, and being married or partnered. The relationships of intrinsic capacity with dietary patterns and alcohol drinking were contradictory across studies. Research on the associations of working status, housing environments, and healthcare accessibility with intrinsic capacity was insufficient to draw conclusions. CONCLUSION: These findings highlight roles of socioeconomic status, lifestyles, and psychosocial factors in improving intrinsic capacity thus promoting healthy ageing. Future research is needed to investigate causal relationships between social determinants and intrinsic capacity, especially material circumstances and healthcare systems.
背景:世界卫生组织将健康老龄化定义为随着年龄增长而保持功能能力。内在能力是健康老龄化的衡量标准,可受到社会决定因素的影响。然而,对于多种社会决定因素如何影响内在能力,我们仍缺乏全面的认识。我们旨在总结观察性研究,以了解社区居住的成年人的社会决定因素与内在能力之间的关系。
方法:通过 Medline、Embase、PsycInfo、Web of Science 和 CINAHL 进行了系统检索,检索截至 2023 年 8 月 14 日。
结果:在回顾了 813 篇文章后,我们纳入了来自亚洲、欧洲和美洲 9 个国家的 21 项研究。其中 17 项研究采用了横断面设计,其余为纵向研究。与内在能力相关的社会决定因素可分为五个领域,包括社会经济地位(16 项,占 76.2%)、生活方式(14 项,占 66.7%)、心理社会因素(9 项,占 42.9%)、物质环境(4 项,占 19.0%)和医疗保健系统(1 项,占 4.8%)。有强有力的证据表明,更好的内在能力与更高的教育水平、更高的财富、更多的身体活动、不吸烟、更多的社交参与以及已婚或伴侣关系有关。关于饮食模式和饮酒与内在能力之间的关系,研究结果存在矛盾。关于工作状况、住房环境和医疗保健可及性与内在能力之间的关联研究还不足以得出结论。
结论:这些发现强调了社会经济地位、生活方式和心理社会因素在提高内在能力从而促进健康老龄化方面的作用。需要进一步的研究来探讨社会决定因素与内在能力之间的因果关系,特别是物质环境和医疗保健系统。
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