Operative Research Unit of Geriatrics, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
Medicina (Kaunas). 2024 Oct 3;60(10):1621. doi: 10.3390/medicina60101621.
Perceived health status (PHS) is associated with various health outcomes in older adults, but its relationship with resilience in the context of events with a major impact on functional status (FS), such as hip fracture, has not been explored. Our objective was to evaluate whether older adults who report good PHS before a hip fracture have a higher probability of returning to their baseline physical performance (PP) and personal independence. We analyzed data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, enrolling patients ≥ 65 years who experienced a hip fracture between these two waves. As study outcomes, we analyzed changes in PP and functional abilities (FAs). We included 149 participants with a mean age of 75.7 years (SD: 6.5); women comprised 66%. The incidence of loss of PP was 51.7% among participants with good PHS and 59.6% among those with poor PHS. FA worsened in 40% of participants with good PHS and 58.4% in those with poor PHS. Relative risk (RR) for loss of FA in people with good PHS was 0.68 (95% CI: 0.48-0.98), which did not change after an adjustment for age, gender, baseline FA, depression, number of comorbidities, education, income, and social support, despite it not reaching statistical significance. After adjustment, the risk of worsening PP in participants with good PHS was reduced by 34% (95% CI: 0.41-1.06). A simple question on PHS may predict the resilience of older adults after an acute stressor. A systematic evaluation of PHS can help identify patients with a higher probability of regaining function after a hip fracture and thus provide useful information for resource allocation.
健康感知状况(PHS)与老年人的各种健康结果相关,但在事件对功能状态(FS)有重大影响的背景下,其与韧性的关系尚未得到探索,如髋部骨折。我们的目的是评估在髋部骨折之前报告良好 PHS 的老年人是否更有可能恢复其基线身体表现(PP)和个人独立性。我们分析了欧洲健康、老龄化和退休研究(SHARE)调查第 1 波和第 2 波的数据,纳入了这两波之间经历髋部骨折的年龄≥65 岁的患者。作为研究结果,我们分析了 PP 和功能能力(FA)的变化。我们纳入了 149 名平均年龄为 75.7 岁(标准差:6.5)的参与者;女性占 66%。在 PHS 良好的参与者中,PP 丧失的发生率为 51.7%,而 PHS 较差的参与者为 59.6%。在 PHS 良好的参与者中,FA 恶化的比例为 40%,而 PHS 较差的参与者为 58.4%。PHS 良好的人 FA 丧失的相对风险(RR)为 0.68(95%置信区间:0.48-0.98),尽管在调整年龄、性别、基线 FA、抑郁、合并症数量、教育、收入和社会支持后,RR 没有变化,但未达到统计学意义。调整后,PHS 良好的参与者 PP 恶化的风险降低了 34%(95%置信区间:0.41-1.06)。一个关于 PHS 的简单问题可能可以预测老年人在急性应激源后的韧性。对 PHS 的系统评估可以帮助识别在髋部骨折后更有可能恢复功能的患者,从而为资源分配提供有用的信息。