Markides K S, Stroup-Benham C A, Goodwin J S, Perkowski L C, Lichtenstein M, Ray L A
Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston 77555-1153, USA.
Ann Epidemiol. 1996 Sep;6(5):386-91. doi: 10.1016/s1047-2797(96)00061-0.
We examined the relationship of self-reported functional status to common medical conditions using a probability sample of 3050 noninstitutionalized Mexican-American men and women aged 65 or older and residing in the Southwestern United States (Arizona, California, Colorado, New Mexico, and Texas). All subjects were interviewed in person (n = 2,873) or by proxy (n = 177) in their homes during late 1993 and early 1994. The questionnaire obtained information on self-reported functional status and prevalence of arthritis, cancer, diabetes, stroke, heart attack, and hip fracture. The prevalence of medical conditions ranged from 4.1% for hip fracture to 40.8% for arthritis. Prevalence of impairments in seven activities of daily living ranged from 5.4% for eating to 11.7% for bathing, while 25.1% could not walk up and down stairs, and 28.9% could not walk a half mile without help. In multiple logistic regression analyses, previous diagnoses of stroke and hip fracture were most predictive of functional limitations, though all conditions examined (arthritis, cancer, diabetes, stroke, heart attack, and hip fracture) were independently associated with increased odds of impairment in some activities of daily living. In general, the odds for functional impairment associated with specific medical conditions were higher than those previously published for non-Hispanic white populations. The fact that Mexican-American elderly who live in the community and who have medical conditions, especially stroke and hip fracture, are at high risk for functional impairment probably reflects the low rate of institutionalization in this population and has implications for the provision of community-based long-term care services for Mexican-American elderly.
我们使用一个概率样本，对居住在美国西南部（亚利桑那州、加利福尼亚州、科罗拉多州、新墨西哥州和得克萨斯州）的3050名65岁及以上的非机构化墨西哥裔美国男性和女性进行了研究，以考察自我报告的功能状态与常见医疗状况之间的关系。1993年末和1994年初，所有受试者均在家中接受了面对面访谈（n = 2873）或由他人代答（n = 177）。问卷获取了有关自我报告的功能状态以及关节炎、癌症、糖尿病、中风、心脏病发作和髋部骨折患病率的信息。医疗状况的患病率从髋部骨折的4.1%到关节炎的40.8%不等。日常生活的七项活动中的功能障碍患病率从进食的5.4%到洗澡的11.7%不等，而25.1%的人无法上下楼梯，28.9%的人在无人帮助的情况下无法行走半英里。在多元逻辑回归分析中，既往中风和髋部骨折的诊断对功能受限的预测性最强，不过所有检查的状况（关节炎、癌症、糖尿病、中风、心脏病发作和髋部骨折）均与某些日常生活活动功能障碍几率的增加独立相关。总体而言，与特定医疗状况相关的功能障碍几率高于之前针对非西班牙裔白人人群公布的几率。生活在社区且患有医疗状况，尤其是中风和髋部骨折的墨西哥裔美国老年人存在功能障碍的高风险，这一事实可能反映了该人群中机构化比率较低的情况，并对为墨西哥裔美国老年人提供基于社区的长期护理服务具有启示意义。
