Hughes S L, Gibbs J, Dunlop D, Singer R
Multipurpose Arthritis and Musculoskeletal Diseases Center, Northwestern University, Chicago, Illinois.
J Am Geriatr Soc. 1995 Feb;43(2):122-9. doi: 10.1111/j.1532-5415.1995.tb06376.x.
To validate a hierarchical model of hand function in older persons, using longitudinal data.
Longitudinal observational study (2-year data from an ongoing longitudinal study).
689 persons older than age 60, including Continuing Care Retirement Community (n = 230), homebound (n = 204), and ambulatory (n = 255) respondents. Mean age at baseline 76.6 (SD = 8.8).
Independent variables included sociodemographics, physician measures of upper joint impairment, self-reported comorbidity, arthritis pain, depression, and anxiety. The dependent variables included grip strength and a timed manual performance test.
Using generalized estimated equations (GEE) to test our hierarchial model, we found that gender and upper extremity joint impairment were the strongest predictors of a longitudinal measure of grip strength. Grip strength, in turn, along with demographics, comorbidity, and a measure of psychological status, was significantly related to timed manual performance.
The longitudinal analyses confirmed a previous cross-sectional finding that upper extremity joint impairment contributes significantly to reduced grip strength, which, in turn, contributes to reduced hand performance on a timed test.
利用纵向数据验证老年人手部功能的分层模型。
纵向观察性研究（来自一项正在进行的纵向研究的2年数据）。
689名60岁以上的人，包括持续护理退休社区的受访者（n = 230）、居家者（n = 204）和能走动的受访者（n = 255）。基线时的平均年龄为76.6岁（标准差 = 8.8）。
自变量包括社会人口统计学、医生对上肢关节损伤的测量、自我报告的合并症、关节炎疼痛、抑郁和焦虑。因变量包括握力和一项定时手动操作测试。
使用广义估计方程（GEE）来检验我们的分层模型，我们发现性别和上肢关节损伤是握力纵向测量的最强预测因素。反过来，握力以及人口统计学、合并症和心理状态测量与定时手动操作显著相关。
纵向分析证实了之前的横断面研究结果，即上肢关节损伤显著导致握力下降，而握力下降又导致定时测试中手部操作能力下降。
