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更长的时间跨度与老年人死亡率和残疾风险降低相关。

Longer time horizons are associated with reduced risk of mortality and disability in older adults.

作者信息

Bolton Corey J, Kim Namhee, Yu Lei, Wilson Robert S, Boyle Patricia A

机构信息

Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

Aging Ment Health. 2025 Jan;29(1):36-42. doi: 10.1080/13607863.2024.2354339. Epub 2024 Jun 13.

Abstract

OBJECTIVES

Longer time horizons are associated with positive health behaviors, but the associations of time horizons with disability and mortality are less understood. This study aims to test the hypothesis that longer time horizons are associated with decreased disability and mortality in older adults.

METHOD

Participants were 1052 older adults (mean age = 81 ± 7 years) without dementia. Proportional hazard models adjusted for age, sex, and education were used to examine the associations of time horizons with risk of mortality and disability.

RESULTS

During up to 11 years of follow up (mean = 5.7), 317 participants died. In fully adjusted models, longer time horizons were associated with reduced mortality risk (hazard rate [HR] = 0.78, 95% confidence interval [CI] = 0.68-0.89). About 36.7% of participants developed disability in instrumental activities of daily living (ADLs) and 49.3% developed disability in basic ADLs during follow up. Longer time horizons were associated with a reduced risk of disability in basic ADLs (HR = 0.89, 95% CI = 0.79-0.99) but not instrumental ADLs (HR = 0.90, 95% CI = 0.80-1.03).

CONCLUSION

Longer time horizons are associated with a reduced risk of all-cause mortality and disability in basic ADLs among community-dwelling older adults, thus highlighting a potentially modifiable psychological risk factor for negative health outcomes in aging.

摘要

目的

较长的时间视野与积极的健康行为相关,但时间视野与残疾和死亡率之间的关联尚鲜为人知。本研究旨在检验这一假设,即较长的时间视野与老年人残疾和死亡率的降低相关。

方法

研究对象为1052名无痴呆症的老年人(平均年龄 = 81±7岁)。采用针对年龄、性别和教育程度进行调整的比例风险模型,来检验时间视野与死亡风险和残疾风险之间的关联。

结果

在长达11年的随访期间(平均 = 5.7年),317名参与者死亡。在完全调整后的模型中,较长的时间视野与较低的死亡风险相关(风险率[HR]=0.78,95%置信区间[CI]=0.68 - 0.89)。在随访期间,约36.7%的参与者在日常生活工具性活动(ADL)中出现残疾,49.3%的参与者在基本ADL中出现残疾。较长的时间视野与基本ADL中残疾风险的降低相关(HR = 0.89,95%CI = 0.79 - 0.99),但与工具性ADL无关(HR = 0.90,95%CI = 0.80 - 1.03)。

结论

较长的时间视野与社区居住老年人全因死亡率和基本ADL残疾风险的降低相关,从而凸显了一个在衰老过程中可能可改变的对负面健康结果有影响的心理风险因素。

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