Ayuso-Álvarez A, Ortiz C, Fontán J, Rodríguez-Blázquez C, Damián J, López-Cuadrado T, Galán I
National Centre for Epidemiology, Institute of Health Carlos III, Spain; Department of Sociology, School of Economics, Universidad Autónoma de Madrid, Spain.
National Centre for Epidemiology, Institute of Health Carlos III, Spain.
Public Health. 2024 May;230:6-11. doi: 10.1016/j.puhe.2024.02.006. Epub 2024 Mar 8.
The Global Activity Limitation Indicator (GALI) is an instrument that measures long-term overall disability. The objective of this study was to evaluate GALI's predictive value on mortality while examining variations according to sex, age, and educational level.
Longitudinal study.
This longitudinal study was based on 42,991 individuals aged ≥15 years who participated in the 2011-2012 National Health Survey and the 2014 European Health Survey in Spain. These records were linked to mortality data up to December 2021. GALI assessed self-reported functional limitation in the past 6 months and classified individuals into three categories: severely limited, limited but not severely, and not limited. Incidence rate ratios (IRR) were calculated using Poisson regression models, adjusting for sociodemographic, lifestyle, and health status variables.
Compared to individuals with no limitations, those with non-severe limitations had an IRR for mortality of 1.27 (95% CI: 1.16-1.38), and 2.04 (95% CI: 1.81-2.31) in those with severe limitations. Women with severe limitations exhibited a higher IRR (2.32; 95% CI: 1.98-2.71) compared to men (1.73; 95% CI: 1.45-2.08) (P for interaction = 0.005). Individuals <65 years with severe limitations showed a greater association (2.22; 95% CI: 1.58-3.10) than those ≥65 (1.49; 95% CI: 1.32-1.69) (P for interaction <0.001). Among individuals with lower educational attainment, the IRR was 2.08 (95% CI: 1.83-2.37), and 1.87 (95% CI: 1.37-2.56) for the higher education group (P for interaction = 0.017).
GALI is a robust predictor of all-cause mortality in the general population and subgroups. The association is stronger in women, individuals <65 years, and those with lower educational levels.
全球活动受限指标（GALI）是一种衡量长期总体残疾情况的工具。本研究的目的是评估GALI对死亡率的预测价值，同时研究其在性别、年龄和教育水平方面的差异。
纵向研究。
这项纵向研究基于42991名年龄≥15岁的个体，他们参与了2011 - 2012年西班牙全国健康调查以及2014年欧洲健康调查。这些记录与截至2021年12月的死亡率数据相关联。GALI评估了过去6个月内自我报告的功能受限情况，并将个体分为三类：严重受限、受限但不严重、未受限。使用泊松回归模型计算发病率比（IRR），并对社会人口统计学、生活方式和健康状况变量进行了调整。
与无功能受限的个体相比，功能受限但不严重的个体死亡率的IRR为1.27（95%置信区间：1.16 - 1.38），严重功能受限的个体为2.04（95%置信区间：1.81 - 2.31）。严重功能受限的女性的IRR（2.32；95%置信区间：1.98 - 2.71）高于男性（1.73；95%置信区间：1.45 - 2.08）（交互作用P值 = 0.005）。65岁以下严重功能受限的个体比65岁及以上个体的关联更强（2.22；95%置信区间：1.58 - 3.10）比（1.49；95%置信区间：1.32 - 1.69）（交互作用P值<0.001）。在教育程度较低的个体中，IRR为2.08（95%置信区间：1.83 - 2.37），高等教育组为1.87（95%置信区间：1.37 - 2.56）（交互作用P值 = 0.017）。
GALI是一般人群和亚组全因死亡率的有力预测指标。这种关联在女性、65岁以下个体以及教育水平较低的个体中更强。
