Takechi Hajime, Tsuzuki Akira, Yoshino Hiroshi, Okumura Takenori, Kanada Yoshikiyo
Department of Geriatrics and Cognitive Disorders, Fujita Health University, Toyoake, Aichi 470-1192, Japan.
Faculty of Rehabilitation, Fujita Health University, Toyoake, Aichi, Japan.
Age Ageing. 2025 May 31;54(6). doi: 10.1093/ageing/afaf152.
Various health-related concerns experienced daily by older adults, designated here as subjective geriatric complaints (SGCs), and are suspected to be early signs of the decline in quality of life (QOL). This study aims to test the hypothesis that SGCs are significant predictors of future disability and mortality among older adults.
This prospective cohort study was conducted in Japan. A health-related questionnaire was mailed to community-dwelling older adults, and data on the certification of long-term care needs and mortality that occurred over the subsequent 5 years were analysed. The analysis included 10 199 individuals. Thirteen SGCs were classified into six groups. The primary outcome was a composite end point of disability and mortality. Survival time analysis was conducted using Kaplan-Meier analysis and Cox proportional hazard regression models.
The mean age (standard deviation) of participants (52.4% female) at baseline was 73.7 (6.0) years. Over the 5-year study period, 1793 participants (17.6%) were newly certified as requiring long-term care and 931 (9.1%) died. After adjusting for age, sex, depressive mood, and presence of multimorbidity, the hazard ratios (95% confidence intervals) for SGC 1b (circulatory/respiratory complaints) and SGC 3 (neurological complaints) were 1.558 (1.316-1.884, P < 0.001) and 1.355 (1.14-1.61, P = 0.001), respectively.
These findings suggest that SGCs are independent risk factors for a decline in QOL. Additionally, risk varied across different symptom groups within SGCs. These differences should be carefully considered in the management of health for older adults.
老年人日常经历的各种与健康相关的问题，在此被指定为主观老年综合征（SGCs），并被怀疑是生活质量（QOL）下降的早期迹象。本研究旨在检验以下假设：SGCs是老年人未来残疾和死亡的重要预测因素。
这项前瞻性队列研究在日本进行。向居住在社区的老年人邮寄了一份与健康相关的问卷，并分析了随后5年中发生的长期护理需求认证和死亡率数据。分析纳入了10199名个体。13种SGCs被分为6组。主要结局是残疾和死亡的复合终点。使用Kaplan-Meier分析和Cox比例风险回归模型进行生存时间分析。
基线时参与者（52.4%为女性）的平均年龄（标准差）为73.7（6.0）岁。在5年的研究期间，1793名参与者（17.6%）被新认证为需要长期护理，931名（9.1%）死亡。在调整年龄、性别、抑郁情绪和多种疾病并存情况后，SGC 1b（循环/呼吸系统症状）和SGC 3（神经系统症状）的风险比（95%置信区间）分别为1.558（1.316-1.884，P<0.001）和1.355（1.14-1.61，P=0.001）。
这些发现表明，SGCs是生活质量下降的独立危险因素。此外，SGCs中不同症状组的风险各不相同。在老年人的健康管理中应仔细考虑这些差异。
