Zhang Shu, Tange Chikako, Huang Shih-Tsung, Kubota Sayaka, Shimokata Hiroshi, Nishita Yukiko, Otsuka Rei
Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Japan.
Department of Pharmacy, National Yang Ming Chiao Tung University, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming University, Taiwan.
J Nutr Health Aging. 2025 Jan;29(1):100432. doi: 10.1016/j.jnha.2024.100432. Epub 2024 Nov 29.
OBJECTIVES: Variability in intrinsic capacity (IC) changes among community-dwelling older adults and their effect on health outcomes remain understudied. We examined the variability in IC trajectories and their impact on higher-level functional capacity (HLFC), life satisfaction, and self-esteem. DESIGN: Longitudinal study. SETTING: Data from the second to seventh waves (2000-2012) of the National Institute for Longevity Sciences-Longitudinal Study of Aging project. PARTICIPANTS: 934 community dwellers (aged ≥60). MEASUREMENTS: We used group-based multi-trajectory modeling to obtain IC trajectories across six domains: cognition, locomotion, vitality, vision, hearing, and psychological well-being. We employed multivariable regression to investigate the associations between IC trajectories and a decline in HLFC (assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence [TMIG-IC]; baseline TMIG-IC - follow-up TMIG-IC ≥ 2; logistic regression model), life satisfaction (assessed using the Life Satisfaction Index-K [LSI-K]; linear mixed model), and self-esteem (assessed using the Rosenberg Self-Esteem Scale [RSES]; linear mixed model). RESULTS: We identified four IC trajectories: the "healthy aging group" (63.7%), the "hearing decline group" (15.1%), the "vision and cognitive decline group" (12.7%), and the "comprehensive deterioration group" (8.5%). Compared to the healthy aging group, the vision and cognitive decline group and the comprehensive deterioration group displayed a significantly greater risk of a decline in the TMIG-IC score (multivariable-adjusted odds ratio [aOR], 95% confidence interval [CI] = 2.05 [1.11, 3.79], 2.74 [1.41, 5.30], respectively), the LSI-K score (multivariable-adjusted β [standard error] = -0.46 [0.08], -0.52 [0.10], respectively), and the RSES score (multivariable-adjusted β [standard error] = -0.85 [0.16], -0.66 [0.20], respectively). The "hearing decline group" did not show a significantly increased risk for these outcomes. CONCLUSION: Older adults with different IC trajectories may differ in HLFC, life satisfaction, and self-esteem. Public health officials should be aware of this and provide targeted interventions.
目的：社区居住老年人内在能力（IC）变化的变异性及其对健康结局的影响仍未得到充分研究。我们研究了IC轨迹的变异性及其对更高水平功能能力（HLFC）、生活满意度和自尊的影响。 设计：纵向研究。 背景：国立长寿科学研究所-老龄化纵向研究项目第二至七波（2000 - 2012年）的数据。 参与者：934名社区居民（年龄≥60岁）。 测量方法：我们使用基于组的多轨迹模型来获取六个领域的IC轨迹：认知、运动、活力、视力、听力和心理健康。我们采用多变量回归来研究IC轨迹与HLFC下降（使用东京都老人综合研究所能力指数[TMIG - IC]评估；基线TMIG - IC - 随访TMIG - IC≥2；逻辑回归模型）、生活满意度（使用生活满意度指数 - K[LSI - K]评估；线性混合模型）和自尊（使用罗森伯格自尊量表[RSES]评估；线性混合模型）之间的关联。 结果：我们确定了四种IC轨迹：“健康老龄化组”（63.7%）、“听力下降组”（15.1%）、“视力和认知下降组”（12.7%）和“全面衰退组”（8.5%）。与健康老龄化组相比，视力和认知下降组以及全面衰退组在TMIG - IC评分下降（多变量调整优势比[aOR]，95%置信区间[CI]=2.05[1.11, 3.79]，2.74[1.41, 5.30]）、LSI - K评分（多变量调整β[标准误]= - 0.46[0.08]， - 0.52[0.10]）和RSES评分（多变量调整β[标准误]= - 0.85[0.16]， - 0.66[0.20]）方面显示出显著更高的风险。“听力下降组”在这些结局方面未显示出显著增加的风险。 结论：具有不同IC轨迹的老年人在HLFC、生活满意度和自尊方面可能存在差异。公共卫生官员应意识到这一点并提供有针对性的干预措施。
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