Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan.
Department of Preventive Geronotology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
J Am Med Dir Assoc. 2024 Jun;25(6):104973. doi: 10.1016/j.jamda.2024.02.011. Epub 2024 Mar 31.
Although going out has been reported to be associated with the incidence of disability, few studies have investigated the effect of community-based programs to promote going out on the incidence of disability. This study aimed to estimate the effects of a program fostering going-out on the incidence of disability in community-dwelling older adults.
Longitudinal, observational study.
Nonengaged (n = 1086) and engaged older adults (n = 1086) enrolled in the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome by using a one-to-one nearest neighbor propensity score-matching scheme.
After the baseline assessments, participants in the community-based going-out program received a specialized physical activity tracker, monitored their daily physical activity, and received personalized feedback on going out to community facilities with a system for reading the device for 12 months. Disability onset was defined as a new case of long-term care under the public insurance certification in Japan within 48 months of program completion. The absolute risk reduction and the number needed to treat for the incidence of disability were calculated for the nonengaged and engaged groups. Cox proportional hazard regression analysis, using inverse probability weighting was used to obtain the hazard ratio.
Disabilities occurred in 112 individuals in the matched nonengaged group and 51 individuals in the engaged group. The absolute risk reduction was 5.67% (95% CI 3.46%-7.88%). The number needed to treat was 18 (95% CI 13-29). The hazard ratio, with the nonengaged group as the reference, was 0.49 (95% CI 0.36-0.67).
This longitudinal observational study suggested that a community-based program could prevent 1 disability in every 18 participants. This program does not require a professional instructor, only the distribution of devices and system installation, and it could be beneficial as a population-based approach to preventing disabilities.
尽管外出活动已被报道与残疾的发生有关，但很少有研究调查促进外出的社区为基础的方案对残疾发生的影响。本研究旨在评估促进外出的方案对社区居住的老年人残疾发生的影响。
纵向观察性研究。
采用一对一最近邻居倾向评分匹配方案，使用全国老年医学研究中心老年综合征研究纳入未参与（n=1086）和参与（n=1086）的不活跃老年人。
在基线评估后，社区外出方案的参与者收到了专门的体育活动追踪器，监测他们的日常体育活动，并通过系统读取设备获得个性化的外出社区设施的反馈，为期 12 个月。残疾发作的定义是在方案完成后 48 个月内根据日本公共保险认证新出现的长期护理案例。计算了未参与组和参与组残疾发生率的绝对风险降低和需要治疗的人数。使用逆概率加权的 Cox 比例风险回归分析获得风险比。
在匹配的未参与组中，112 名个体发生了残疾，在参与组中，51 名个体发生了残疾。绝对风险降低为 5.67%（95%CI 3.46%-7.88%）。需要治疗的人数为 18（95%CI 13-29）。以未参与组为参照，风险比为 0.49（95%CI 0.36-0.67）。
这项纵向观察性研究表明，社区为基础的方案可预防每 18 名参与者中的 1 例残疾。该方案不需要专业的指导员，只需分发设备和系统安装，作为一种基于人群的预防残疾的方法可能是有益的。
