预防性健康服务对日本大阪某社区老年人存活率的影响。

Effects of preventive health services on survival of the elderly living in a community in Osaka, Japan.

作者信息

Nakanishi N, Tatara K, Tatatorige T, Murakami S, Shinsho F

机构信息

Department of Public Health, Osaka University Medical School, Japan.

出版信息

J Epidemiol Community Health. 1997 Apr;51(2):199-204. doi: 10.1136/jech.51.2.199.

DOI:10.1136/jech.51.2.199

PMID:9196652

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1060445/

Abstract

STUDY OBJECTIVE

To examine the relationships between the use of preventive health services--such as health checks, basic health examination/cancer screening, and daily preventive health practices--and survival of elderly people living in the community.

DESIGN AND SETTING

A cohort of elderly people aged 65 years and over living in Settsu City, Osaka was followed for 38 months. Data on the history of health management, disability scores, and psychosocial conditions were collected in October 1992 by interview during home visits.

SUBJECTS

Of the 1491 people randomly selected from the computerised sex-age register at enrollment, 1473 were contacted and responses were obtained from 1405 (95.4%). They constituted the study cohort. Follow up was completed for 1325 (94.3%) (154 decreased and 1171 alive).

MEASUREMENTS AND MAIN RESULTS

From the analysis using the Kaplan-Meier method and the log-rank test, female sex, younger age group (65-74 years), use of health checks, use of basic health examination and/or cancer screening, use of daily preventive health practices, less disability, taking part in social activity, and finding life worth living were univariately statistically significantly related to survival. The estimated survival rates were highest in those with regular health checks or daily preventive health practices before 59 years of age or both basic health examination and cancer screening. From the Cox proportional hazards model, use of health checks and use of daily preventive health practices remained as statistically significant factors associated with survival, controlling for other factors such as sex, age group, medical treatment, disability scores, and psycho-social conditions, and these hazard ratios (not used v starting at 59 years) were 0.41 (95% CI, 0.25, 0.66) and 0.52 (95% CI, 0.30, 0.88), respectively.

CONCLUSIONS

Health management efforts such as health checks and daily preventive health practices may increase survival in the elderly.

摘要

研究目的

探讨预防性健康服务的使用情况（如健康检查、基本健康检查/癌症筛查以及日常预防性健康行为）与社区老年人存活率之间的关系。

设计与研究地点

对居住在大阪府堺市的1491名65岁及以上老年人进行了为期38个月的队列研究。1992年10月通过家访面谈收集了健康管理史、残疾评分和心理社会状况的数据。

研究对象

从登记时的计算机性别年龄登记册中随机抽取1491人，其中1473人被联系上，1405人（95.4%）给予了回复。他们构成了研究队列。对1325人（94.3%）完成了随访（154人失访，1171人存活）。

测量指标与主要结果

通过使用Kaplan-Meier法和对数秩检验进行分析，结果显示女性、较年轻年龄组（65 - 74岁）、进行健康检查、进行基本健康检查和/或癌症筛查、采取日常预防性健康行为、残疾程度较轻、参与社会活动以及认为生活有意义，在单因素分析中与存活率在统计学上有显著关联。在59岁之前定期进行健康检查或日常预防性健康行为，或同时进行基本健康检查和癌症筛查的人群中，估计存活率最高。根据Cox比例风险模型，在控制了性别、年龄组、医疗治疗、残疾评分和心理社会状况等其他因素后，健康检查的使用和日常预防性健康行为的采取仍然是与存活率相关的统计学显著因素，这些风险比（未使用与59岁开始使用相比）分别为0.41（95%可信区间，0.25，0.66）和0.52（95%可信区间，0.30，0.88）。