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老年人群身体残疾的风险因素:美国国家健康与营养检查调查I流行病学随访研究

Risk factors for physical disability in an aging cohort: the NHANES I Epidemiologic Followup Study.

作者信息

Hubert H B, Bloch D A, Fries J F

机构信息

Department of Medicine, Stanford University Medical Center, Palo Alta, CA 94304-1808.

出版信息

J Rheumatol. 1993 Mar;20(3):480-8.

PMID:8478855
Abstract

Successful improvement in health in our increasingly aged population will depend in substantial part on reduction of age specific disability levels. In turn, the epidemiologic model suggests that this requires identification of risk factors, development of intervention models, and testing of these models. We attempted to identify risk factors for physical disability among 4,428 50-77-year-olds using baseline data collected in the first National Health and Nutrition Examination Survey (NHANES I) (1971-1975) linked to disability data collected 10 years later in the NHANES I Epidemiologic Followup Study. Results of forward stepwise linear regression analysis showed that the major characteristics contributing to greater disability (explaining at least 1% of the variability in scores) were older age at baseline, less nonrecreational activity, arthritis history, less education, female sex, and greater body mass index at age 40. Other factors associated with greater disability included a history of asthma, cardiovascular disease, abnormal urine test, less recreational activity, higher sedimentation rate, rheumatic fever history, lower caloric intake, positive musculoskeletal findings, histories of polio and allergies, lower family income, elevated blood pressure, lower serum albumin, history of tuberculosis, glucose in the urine, and histories of hip or spine fracture, chronic pulmonary disease, and kidney disease.

摘要

在我们日益老龄化的人口中,健康状况的成功改善在很大程度上取决于特定年龄残疾水平的降低。反过来,流行病学模型表明,这需要识别风险因素、开发干预模型并对这些模型进行测试。我们试图利用在第一次全国健康和营养检查调查(NHANES I,1971 - 1975年)中收集的基线数据,结合10年后在NHANES I流行病学随访研究中收集的残疾数据,来识别4428名50 - 77岁人群身体残疾的风险因素。逐步向前线性回归分析结果表明,导致残疾程度加重的主要特征(解释分数变异性至少1%)包括基线时年龄较大、非娱乐活动较少、有关节炎病史、受教育程度较低、女性、40岁时体重指数较高。与残疾程度加重相关的其他因素包括哮喘病史、心血管疾病、尿检异常、娱乐活动较少、血沉率较高、风湿热病史、热量摄入较低、肌肉骨骼检查结果阳性、小儿麻痹症和过敏病史、家庭收入较低、血压升高、血清白蛋白较低、结核病病史、尿糖、髋部或脊柱骨折病史、慢性肺病和肾病病史。

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