Seeman T E, Berkman L F, Charpentier P A, Blazer D G, Albert M S, Tinetti M E
Department of Epidemiology and Public Health, Yale University School of Medicine, USA.
J Gerontol A Biol Sci Med Sci. 1995 Jul;50(4):M177-83. doi: 10.1093/gerona/50a.4.m177.
Performance-based measures of physical performance are examined for an older cohort of relatively high-functioning men and women. The influences of baseline behavioral, social, and psychological characteristics on patterns of change in performance over 2.5 years are examined.
A cohort of relatively high-functioning men and women, aged 70-79, identified in 1988 by subsampling from three community-based studies on the basis of physical and cognitive function. Baseline assessments included physical performance, sociodemographic characteristics, health status, and behavioral, social, and psychological characteristics. A summary measure of physical performance was developed from tests of balance, gait, lower body strength and coordination, and manual dexterity. In-home assessments were repeated at follow-up in 1991.
Linear regression models were used to identify significant behavioral, social, and psychological predictors of better performance at follow-up, controlling for known sociodemographic and health status predictors. Significant, independent associations with better performance were found for participation in moderate and/or strenuous exercise activity and greater frequency of emotional support from social networks, particularly among those reporting low frequency of instrumental support. These effects remained significant independent of incident health conditions during follow-up. None of the psychological characteristics was a significant predictor.
Maintenance of better physical performance within a high-functioning cohort is influenced by prior exercise behavior and social network emotional support. Observed patterns of both decline and improvement in performance suggest that older age is not uniformly associated with declines. Predictors of better performance identified here may offer potential for effective interventions to promote more successful aging.
对一组年龄较大、功能相对较高的男性和女性进行基于表现的身体机能测量。研究基线行为、社会和心理特征对2.5年期间机能变化模式的影响。
1988年从三项基于社区的研究中，根据身体和认知功能进行二次抽样，确定了一组年龄在70 - 79岁、功能相对较高的男性和女性。基线评估包括身体机能、社会人口统计学特征、健康状况以及行为、社会和心理特征。通过平衡、步态、下肢力量与协调性以及手部灵巧性测试得出身体机能的综合测量值。1991年随访时再次进行家庭评估。
使用线性回归模型确定随访时机能表现更好的显著行为、社会和心理预测因素，同时控制已知的社会人口统计学和健康状况预测因素。结果发现，参与中度和/或剧烈运动活动以及社交网络中情感支持频率较高与机能表现更好存在显著的独立关联，特别是在那些报告工具性支持频率较低的人群中。这些影响在随访期间独立于突发健康状况仍然显著。没有任何心理特征是显著的预测因素。
机能相对较高的人群中，更好的身体机能维持受到先前运动行为和社交网络情感支持的影响。观察到的机能下降和改善模式表明，衰老并不总是与机能下降相关。此处确定的机能表现更好的预测因素可能为促进更成功衰老的有效干预措施提供潜力。
