Boult C, Kane R L, Louis T A, Boult L, McCaffrey D
Department of Family Practice and Community Health, University of Minnesota Medical School.
J Gerontol. 1994 Jan;49(1):M28-36. doi: 10.1093/geronj/49.1.m28.
The role of chronic medical conditions in elderly persons' loss of functional abilities is intuitively important but not well defined. This analysis was designed to identify chronic medical conditions that lead to the development of severe functional limitation.
Functionally intact members of a multistage probability sample (n = 6,862) of all noninstitutionalized U.S. civilians age 70 years or older were interviewed in 1984. Based on data from the National Death Index and from follow-up telephone interviews in 1988 with survivors, subjects were classified as functionally intact, functionally limited (unable to perform one or more of seven essential activities), or decreased.
After adjusting for the effects of exercise habits and demographic, socioeconomic, and psychosocial factors, we found that the best predictors of the development of functional limitation were cerebrovascular disease (OR = 2.14; 95% CL = 1.16, 3.98) and arthritis (OR = 1.51; 95% CL = 1.08, 2.11). The contribution of coronary artery disease also approached statistical significance (OR = 1.49; 95% CL = 0.99, 2.27).
In the future, the primary prevention or effective treatment of cerebrovascular disease, arthritis, and possibly coronary artery disease may produce a modest reduction in the incidence of severe functional limitation.
慢性疾病在老年人功能丧失中所起的作用从直观上看很重要，但尚未明确界定。本分析旨在确定导致严重功能受限的慢性疾病。
1984年对年龄在70岁及以上的所有非机构化美国平民的多阶段概率样本（n = 6,862）中功能完好的成员进行了访谈。根据国家死亡指数的数据以及1988年对幸存者进行的随访电话访谈的数据，将受试者分为功能完好、功能受限（无法进行七项基本活动中的一项或多项）或功能下降。
在对运动习惯以及人口统计学、社会经济和心理社会因素的影响进行调整后，我们发现功能受限发展的最佳预测因素是脑血管疾病（OR = 2.14；95%可信区间 = 1.16, 3.98）和关节炎（OR = 1.51；95%可信区间 = 1.08, 2.11）。冠状动脉疾病的影响也接近统计学显著性（OR = 1.49；95%可信区间 = 0.99, 2.27）。
未来，对脑血管疾病、关节炎以及可能的冠状动脉疾病进行一级预防或有效治疗，可能会使严重功能受限的发生率略有降低。
