Lu Zhihui, Leung Jason, Auyeung T W, Lee Jenny, Lo Kenneth, Lai King-Son, Lam Kuen, Woo Jean, Kwok Timothy
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Gerontology. 2025;71(2):81-87. doi: 10.1159/000543378. Epub 2025 Jan 2.
This study aimed to identify the different patterns of trajectories in instrumental activities of daily living (IADL) in older men and women, respectively, and to examine the factors associated with the different trajectories.
We included 2,088 participants with an average age of 70.8 years at baseline from the MrOS and MsOS Hong Kong cohort study (men: 1,074; women: 1,014) and followed up the participants for over 14 years. The group-based trajectory models were used to identify IADL trajectories. Binary logistic regression and multinominal logistic regression models were used to identify factors associated with different trajectories.
Two distinct trajectories were identified for men including "slow decliners" (92.6% of men) and "rapid decliners" (7.4%), while three distinct trajectories were identified for women including "slow decliners" (43.5% of women), "intermediate decliners" (48.2%), and "rapid decliners" (8.3%). Being overweight or obese and slow walking speed were common predictors of more rapid IADL declining trajectories in both men and women. Particularly, having stroke, weak grip strength, and higher level of PM2.5 were associated with the higher risk of being rapid decliners in men, and having osteoporosis and poor self-rated health were associated with more rapid IADL declining trajectories in women.
Sex differences were observed in the IADL declining trajectories. Several risk factors were found that could possibly be useful in identifying and preventing functional impairments in an earlier stage.
本研究旨在分别确定老年男性和女性在日常生活工具性活动（IADL）中的不同轨迹模式，并研究与不同轨迹相关的因素。
我们纳入了来自香港MrOS和MsOS队列研究的2088名基线平均年龄为70.8岁的参与者（男性：1074名；女性：1014名），并对参与者进行了超过14年的随访。基于群体的轨迹模型用于确定IADL轨迹。二元逻辑回归和多项逻辑回归模型用于确定与不同轨迹相关的因素。
男性确定了两种不同的轨迹，包括“缓慢衰退者”（占男性的92.6%）和“快速衰退者”（占7.4%），而女性确定了三种不同的轨迹，包括“缓慢衰退者”（占女性的43.5%）、“中度衰退者”（占48.2%）和“快速衰退者”（占8.3%）。超重或肥胖以及步行速度慢是男性和女性IADL衰退轨迹更快的常见预测因素。特别是，中风、握力弱和较高的PM2.5水平与男性成为快速衰退者的较高风险相关，而骨质疏松症和自评健康状况差与女性IADL衰退轨迹更快相关。
在IADL衰退轨迹中观察到性别差异。发现了几个可能有助于在早期识别和预防功能障碍的风险因素。
