Huang Mei-Tzu, Chang Ya-Hui, Li Chung-Yi, Elizabeth Ku Li-Jung, Chou Yu-Tsung, Hou Wen-Hsuan, Chen Hung-Yu, Su Hui-Chen, Wu Yi-Lin, Liu Chieh-Hsiu, Yang Yi-Ching, Chen Pei-Chun
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan.
Prev Med Rep. 2024 Oct 9;47:102897. doi: 10.1016/j.pmedr.2024.102897. eCollection 2024 Nov.
OBJECTIVES: The World Health Organization's Integrated Care for Older People (ICOPE) framework launched in 2019 is used to assess the intrinsic capacity of older individuals. Older women may face greater socioeconomic disadvantages, which can impact their physical and mental well-being. Therefore, we examined sex differences in intrinsic capacity and the influence of socioeconomic status. METHODS: We conducted a cross-sectional study in Tainan, Taiwan, recruiting 1,268 adults aged 60 or older in 2022. The ICOPE screening assessed cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms. Intrinsic capacity scores ranged from 0 to 6 and were categorized as impairment (1 or higher) or no impairment (0). Binary logistic regression models were used to analyze sex differences in intrinsic capacity, adjusting sequentially for demographics, lifestyle, and socioeconomic factors. RESULTS: The prevalence of intrinsic capacity impairment was 34 %. Women had significantly higher odds of intrinsic capacity impairment (women vs. men, odds ratio [OR] = 1.39, 95 % CI = 1.10-1.75). After sequentially adjusting for demographic characteristics, lifestyle, and socioeconomic factors, the ORs were 1.46 (95 % CI = 1.12-1.90), 1.69 (95 % CI = 1.23-2.31), and 1.24 (95 % CI = 0.88-1.73), respectively. Stratified analyses showed that higher odds of impairment in women than in men was evident only in the financially dependent group (P for interaction = 0.059). CONCLUSIONS: Older women in Taiwan have poorer intrinsic capacity than men, a disparity largely attributable to women's lower socioeconomic status. Strategies to promote healthy aging among women from disadvantaged socioeconomic backgrounds may help mitigate this sex difference in intrinsic capacity.
目的:世界卫生组织于2019年推出的老年人综合照护(ICOPE)框架用于评估老年人的内在能力。老年女性可能面临更大的社会经济劣势,这会影响她们的身心健康。因此,我们研究了内在能力的性别差异以及社会经济地位的影响。 方法:我们在台湾台南进行了一项横断面研究,于2022年招募了1268名60岁及以上的成年人。ICOPE筛查评估了认知衰退、行动不便、营养不良、视力障碍、听力损失和抑郁症状。内在能力得分范围为0至6,并分为受损(1分及以上)或未受损(0分)。二元逻辑回归模型用于分析内在能力的性别差异,并依次对人口统计学、生活方式和社会经济因素进行调整。 结果:内在能力受损的患病率为34%。女性内在能力受损的几率显著更高(女性与男性相比,优势比[OR]=1.39,95%置信区间[CI]=1.10-1.75)。在依次调整人口统计学特征、生活方式和社会经济因素后,优势比分别为1.46(95%CI=1.12-1.90)、1.69(95%CI=1.23-2.31)和1.24(95%CI=0.88-1.73)。分层分析表明,仅在经济依赖组中,女性受损几率高于男性的情况明显(交互作用P=0.059)。 结论:台湾老年女性的内在能力比男性差,这种差异在很大程度上归因于女性较低的社会经济地位。促进社会经济背景不利的女性健康老龄化的策略可能有助于减轻内在能力方面的这种性别差异。
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