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社会支持是否调节了社区居住的老年人衰弱与功能能力轨迹之间的关系?

Does Social Support Moderate the Relationship Between Frailty and Functional Ability Trajectory Among Community-Dwelling Older Adults?

机构信息

School of Nursing, Peking University, Beijing, China.

出版信息

J Gerontol A Biol Sci Med Sci. 2024 Aug 1;79(8). doi: 10.1093/gerona/glae145.

DOI:10.1093/gerona/glae145
PMID:38813979
Abstract

BACKGROUND

Functional ability is the important prerequisite to live independently and achieve aging in place, which depends on the complex interaction of intrinsic and extrinsic factors. Identifying the trends and influencing factors of functional ability would contribute to the accurate assessment and intervention of geriatric health. This study aimed to disentangle the moderating effect of 3 types of social support, namely objective support, subjective support, and support utilization, on the relationship between frailty and functional ability trajectories.

METHODS

This was a secondary analysis using data from a prospective 3-wave study with a sample of 777 Chinese community-dwelling older adults. Social support was assessed using the Social Support Rating scale. Frailty was assessed using the FRAIL scale. Functional ability was measured by the Lawton Instrumental Activities of Daily Living scale. Latent growth curve models were implemented to test their relationships.

RESULTS

Objective support but not subjective support or support utilization moderated on the relationship between frailty and functional ability slope. Functional ability decline over time was buffered by objective support among robust individuals but exacerbated among (pre)frail individuals.

CONCLUSIONS

The moderating effect of social support on the relationship between frailty and functional ability trajectory varies by support types, which reminded that social support may be a promising intervention target to maintain functional independence for frail individuals, opening up a new perspective on social support in the field of disability prevention. Effective interventions should particularly address objective support in conjunction with empowering the frail older population to optimize the trajectory of functional ability.

摘要

背景

功能能力是独立生活和实现原地老龄化的重要前提,这取决于内在和外在因素的复杂相互作用。确定功能能力的趋势和影响因素将有助于对老年健康进行准确评估和干预。本研究旨在探讨三种类型的社会支持(客观支持、主观支持和支持利用)对衰弱与功能能力轨迹之间关系的调节作用。

方法

这是一项使用来自具有 777 名中国社区居住的老年人的前瞻性 3 波研究数据的二次分析。社会支持采用社会支持评定量表进行评估。衰弱采用 FRAIL 量表进行评估。功能能力通过 Lawton 工具性日常生活活动量表进行测量。采用潜在增长曲线模型来检验它们之间的关系。

结果

客观支持而非主观支持或支持利用调节了衰弱与功能能力斜率之间的关系。在健壮个体中,客观支持缓冲了功能能力随时间的下降,但在(前)衰弱个体中则加剧了这种下降。

结论

社会支持对衰弱与功能能力轨迹之间关系的调节作用因支持类型而异,这提醒我们,社会支持可能是维持衰弱个体功能独立性的一个有前途的干预目标,为残疾预防领域的社会支持开辟了一个新视角。有效的干预措施应特别关注客观支持,并赋予衰弱的老年人群体权力,以优化功能能力的轨迹。

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