Ensrud K E, Nevitt M C, Yunis C, Cauley J A, Seeley D G, Fox K M, Cummings S R
Dept. of Medicine (111-M), VA Medical Center, Minneapolis, MN 55417.
J Am Geriatr Soc. 1994 May;42(5):481-9. doi: 10.1111/j.1532-5415.1994.tb04968.x.
To determine the factors associated with impaired function in older women.
Cross-sectional analysis of baseline data collected for a multicenter, prospective study of risk factors for osteoporotic fractures.
Four clinical centers in Portland, Oregon, Minneapolis, Minnesota, Baltimore, Maryland, and the Monongahela Valley, Pennsylvania.
A total of 9,704 ambulatory, non-black women, aged 65 years and older, recruited from population-based listings.
Independent variables, including demographic and historical information (medical conditions, health habits, and medications) and physiologic measures (anthropometry, blood pressure, mental status, vision, and neuromuscular performance) were obtained from a baseline questionnaire, interview, and examination. Measurement of function was assessed by self-reported ability to perform six physical and instrumental activities of daily living (ADL) and impaired function (dependent variable) was defined as difficulty performing three or more physical and instrumental ADLs.
In order of decreasing strength of association, hip fracture, osteoarthritis, parkinsonism, slower walking speed, lower hip abduction force, back pain, greater Quetelet index, osteoporosis, former alcohol use, stroke, never drinking alcohol, lower mental status, use of anxiolytics and/or sleeping medications, inability to hold the tandem position, postural dizziness, cataracts, greater waist to hip ratio, lower physical activity in the past year, greater lifetime cigarette consumption, and lower grip strength were independently associated with impaired function in multivariate analyses. Age, low educational level, diabetes, current heavy alcohol use, postural hypotension, depth perception, and contrast sensitivity were not independent predictors. A combination of neuromuscular performance measures, including decreased muscle strength and impaired balance and gait, appeared to account for the effect of age on disability.
A combination of many factors, including medical conditions, health habits such as obesity, smoking, alcohol abstinence, and physical inactivity, and direct measures of neuromuscular performance are associated with impaired function in older women.
确定老年女性功能受损的相关因素。
对一项关于骨质疏松性骨折危险因素的多中心前瞻性研究收集的基线数据进行横断面分析。
俄勒冈州波特兰、明尼苏达州明尼阿波利斯、马里兰州巴尔的摩和宾夕法尼亚州莫农加希拉谷的四个临床中心。
从基于人群的列表中招募的总共9704名65岁及以上的非黑人门诊女性。
自变量包括人口统计学和病史信息（医疗状况、健康习惯和药物治疗）以及生理指标（人体测量学、血压、精神状态、视力和神经肌肉功能），这些信息通过基线问卷、访谈和检查获得。功能测量通过自我报告的进行六项身体和日常生活工具性活动（ADL）的能力来评估，功能受损（因变量）定义为难以进行三项或更多身体和日常生活工具性ADL。
按照关联强度递减的顺序，髋部骨折、骨关节炎、帕金森病、步行速度较慢、髋外展力量较低、背痛、体重指数较高、骨质疏松症、既往饮酒史、中风、从不饮酒、精神状态较低、使用抗焦虑药和/或安眠药、无法保持串联姿势、体位性头晕、白内障、腰臀比更高、过去一年身体活动较少、终生吸烟量更大以及握力较低在多变量分析中与功能受损独立相关。年龄、低教育水平、糖尿病、当前大量饮酒、体位性低血压、深度知觉和对比敏感度不是独立的预测因素。包括肌肉力量下降以及平衡和步态受损在内的多种神经肌肉功能测量指标的组合似乎可以解释年龄对残疾的影响。
多种因素的组合，包括医疗状况、肥胖、吸烟、戒酒和身体不活动等健康习惯以及神经肌肉功能的直接测量指标，与老年女性功能受损有关。
