Laukkanen P, Sakari-Rantala R, Kauppinen M, Heikkinen E
Department of Health Sciences, University of Jyväskylä, Finland.
Scand J Soc Med Suppl. 1997;53:79-106.
Purpose of this report is to describe the changes that occurred in morbidity, symptoms of illness and disability of 75- and 80-year-old residents of Jyväskylä, Finland, over a five-year period. The study population consisted of the elderly residents of the city of Jyväskylä in central Finland who were born in 1914 and 1910. At baseline (in 1989 and 1990), 355 (92.9%) persons from the younger age group and 262 (91.9%) from the older age group were interviewed and 311 (81.4%) and 230 (80.7%), respectively, took part in the physical examination. At follow-up (in 1994 and 1995), the corresponding numbers were 250 (93.3%) and 148 (88.6%) for the interviews and 217 (81.0%) and 127 (76.0%) for the physical examinations. The prevalence of chronic conditions was determined in connection with the medical examinations on the basis of self-report and the respondent's prescriptions and medical information cards. To measure the occurrence of symptoms, the respondents were asked whether during the past 14 days they had suffered from any of 17 listed symptoms. Functional capacity was assessed in connection with the interview carried out at the respondent's home in terms of needing help in activities of daily living (ADL). In the baseline examinations, subjects were found to have on average 2-3 diseases. During the follow-up the number of diseases and the proportion of people with co-morbidity increased in both age groups. Both men and women had on average 1-2 symptoms that caused them much trouble, and the number of such symptoms increased to some extent during the follow-up. The proportions of those needing help increased during the follow-up in all groups and the increase was most prominent among the women of the older age group. Of those who managed independently with physical ADL (PADL) at baseline, 14.9%-44.9% reported need of help in at least one task at follow-up. The need for help in PADL was greatest with cutting toe-nails, negotiating stairs, moving outdoors, washing the upper body and in instrumental ADL (IADL) with vacuuming, shopping, handling finances and in the use of public transport. Successful prevention and postponement of functional disabilities in the elderly population depends not only on the early diagnosis of illness but also on identifying even minor signs and symptoms of disease and functional limitations, and to focus health care interventions accordingly.
本报告的目的是描述芬兰于韦斯屈莱市75岁和80岁居民在五年期间发病率、疾病症状和残疾情况的变化。研究人群包括芬兰中部于韦斯屈莱市1914年和1910年出生的老年居民。在基线期（1989年和1990年），较年轻年龄组的355人（92.9%）和较年长年龄组的262人（91.9%）接受了访谈，分别有311人（81.4%）和230人（80.7%）参加了体格检查。在随访期（1994年和1995年），访谈的相应人数为250人（93.3%）和148人（88.6%），体格检查的相应人数为217人（81.0%）和127人（76.0%）。慢性病患病率是在医学检查时根据自我报告、受访者的处方和医疗信息卡确定的。为了衡量症状的发生情况，询问受访者在过去14天内是否出现过列出的17种症状中的任何一种。根据在受访者家中进行访谈时对日常生活活动（ADL）中是否需要帮助的情况评估功能能力。在基线检查中，受试者平均患有2 - 3种疾病。在随访期间，两个年龄组的疾病数量和合并症患者比例均有所增加。男性和女性平均都有1 - 2种给他们带来很大困扰的症状，且此类症状数量在随访期间有所增加。随访期间，所有组中需要帮助的比例都有所增加，在较年长年龄组的女性中增加最为显著。在基线期能够独立完成身体日常生活活动（PADL）的人中，14.9% - 44.9%的人在随访时报告至少在一项任务上需要帮助。在PADL方面，修剪脚趾甲、上下楼梯、外出活动、清洗上半身时最需要帮助，在工具性日常生活活动（IADL）方面，吸尘、购物、处理财务以及使用公共交通时最需要帮助。成功预防和延缓老年人群的功能残疾不仅取决于疾病的早期诊断，还取决于识别疾病和功能受限的哪怕是轻微的体征和症状，并据此集中进行医疗保健干预。
