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老年人内在能力下降轨迹及其相关因素:一项基于北京社区的15年队列研究。

Trajectories of intrinsic capacity decline and related factors in old persons: A 15-year community-based cohort study in Beijing.

作者信息

Li Yuanyuan, Zhang Tingting, Li Minghui, Shen Rui, Wang Xiao, Zhuo Chuanjun, Wang Ying, Yan Fang, Liu Zhaorui, Huang Yueqin

机构信息

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.

出版信息

J Nutr Health Aging. 2025 May;29(5):100526. doi: 10.1016/j.jnha.2025.100526. Epub 2025 Mar 5.

Abstract

BACKGROUND

Intrinsic capacity (IC) is vital to the World Health Organization's healthy ageing framework. This study aims to develop an IC assessment model, and identify its longitudinal trajectories and related factors in old persons.

METHODS

This was a 15-year three-wave prospective cohort study of the 10/66 dementia series researches in Beijing, China. Totally 2 156 community-dwelling old persons aged 65 years and over were included at baseline to develop an IC assessment model, with 474 completing follow-up surveys for IC trajectory identification. IC was assessed using 11 items of the five domains and bifactor-multidimensional item response theory model. The group-based trajectory model and multivariate logistic regression model were employed to identify longitudinal trajectories and related factors of IC.

RESULTS

Three IC trajectories were identified as low baseline IC with rapid descending trajectory (11.39%), medium baseline IC with moderate descending trajectory (75.53%), and high baseline IC with slight descending trajectory (13.08%). Compared to the "slight descending trajectory", aged 75 years and over (aOR: 9.48), female (aOR: 4.75), and unmarried/non-cohabiting (aOR: 4.73) were positively associated with the "rapid descending trajectory". Completed secondary school/higher education (aOR: 0.08; aOR: 0.27), more vegetables/fruits intake (aOR: 0.91; aOR: 0.94), and private restricted support network (aOR: 0.17; aOR: 0.37) were negatively associated with the "rapid descending trajectory" and "moderate descending trajectory".

CONCLUSIONS

Community-dwelling old persons in Beijing exhibit three IC trajectories, with the majority showing moderate descending trajectory. Interventions should address gender or education inequities and modifiable factors like diet and social support to mitigate IC decline.

摘要

背景

内在能力(IC)对世界卫生组织的健康老龄化框架至关重要。本研究旨在开发一种IC评估模型,并确定老年人的IC纵向轨迹及其相关因素。

方法

这是一项在中国北京进行的为期15年、分三波的前瞻性队列研究,属于10/66痴呆系列研究。共有2156名65岁及以上的社区居住老年人在基线时被纳入,以开发IC评估模型,其中474人完成了IC轨迹识别的随访调查。使用五个领域的11个项目和双因素 - 多维项目反应理论模型评估IC。采用基于组的轨迹模型和多变量逻辑回归模型来识别IC的纵向轨迹及其相关因素。

结果

确定了三种IC轨迹,即基线IC低且下降迅速的轨迹(11.39%)、基线IC中等且下降适中的轨迹(75.53%)以及基线IC高且下降轻微的轨迹(13.08%)。与“下降轻微的轨迹”相比,75岁及以上(调整后比值比:9.48)、女性(调整后比值比:4.75)以及未婚/非同居(调整后比值比:4.73)与“下降迅速的轨迹”呈正相关。完成中学/高等教育(调整后比值比:0.08;调整后比值比:0.27)、更多的蔬菜/水果摄入量(调整后比值比:0.91;调整后比值比:0.94)以及私人受限支持网络(调整后比值比:0.17;调整后比值比:0.37)与“下降迅速的轨迹”和“下降适中的轨迹”呈负相关。

结论

北京社区居住的老年人呈现三种IC轨迹,大多数表现为下降适中的轨迹。干预措施应解决性别或教育不平等问题以及饮食和社会支持等可改变因素,以减轻IC下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f00/12180025/c6fe2496cbf9/gr1.jpg

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