Hughes S L, Dunlop D, Edelman P, Chang R W, Singer R H
Center for Health Services and Policy Research, Northwestern University.
J Gerontol. 1994 Nov;49(6):S291-300. doi: 10.1093/geronj/49.6.s291.
Recent longitudinal data indicating that arthritis is a major contributor to disability in elderly persons are based on self-reported diagnostic information. This longitudinal study included baseline physical examinations of joints of 541 persons over age 60. Previous results from a cross-sectional multivariate model of disability in this sample found that joint impairment (and, its absence, arthritis pain) explained a significant proportion of variance in overall disability. We have retested this model using generalized estimation equations (GEE) analysis to estimate the effect of joint impairment and arthritis pain on baseline and Year 2 disability. Findings indicate that baseline joint impairment contributes substantially to longitudinal disability. If direct measures of baseline joint impairment are unavailable, concurrent self-reported arthritis pain also predicts longitudinal disability well. These findings indicate that longitudinal studies should monitor arthritis pain and that symptomatic arthritis is a risk factor for future disability.
近期的纵向数据表明，关节炎是导致老年人残疾的主要因素，这些数据基于自我报告的诊断信息。这项纵向研究包括对541名60岁以上人群的关节进行基线身体检查。此前在该样本中进行的残疾横断面多变量模型研究结果发现，关节损伤（以及无关节损伤，即关节炎疼痛）在总体残疾的方差中占很大比例。我们使用广义估计方程（GEE）分析对该模型进行了重新测试，以估计关节损伤和关节炎疼痛对基线及第二年残疾情况的影响。研究结果表明，基线关节损伤对纵向残疾有很大影响。如果无法获得基线关节损伤的直接测量值，同时自我报告的关节炎疼痛也能很好地预测纵向残疾。这些研究结果表明，纵向研究应监测关节炎疼痛，且有症状的关节炎是未来残疾的一个风险因素。
