Penninx B W, van Tilburg T, Kriegsman D M, Deeg D J, Boeke A J, van Eijk J T
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Am J Epidemiol. 1997 Sep 15;146(6):510-9. doi: 10.1093/oxfordjournals.aje.a009305.
This study focuses on the role of social support and personal coping resources in relation to mortality among older persons in the Netherlands. Data are from a sample of 2,829 noninstitutionalized people aged between 55 and 85 years who took part in the Longitudinal Aging Study Amsterdam in 1992-1995. Social support was operationally defined by structural, functional, and perceived aspects, and personal coping resources included measures of mastery, self-efficacy, and self-esteem. Mortality data were obtained during a follow-up of 29 months, on average. Cox proportional hazards regression models revealed that having fewer feelings of loneliness and greater feelings of mastery are directly associated with a reduced mortality risk when age, sex, chronic diseases, use of alcohol, smoking, self-rated health, and functional limitations are controlled for. In addition, persons who received a moderate level of emotional support (odds ratio (OR) = 0.49, 95% confidence interval (CI) 0.33-0.72) and those who received a high level of support (OR = 0.68, 95% CI 0.47-0.98) had reduced mortality risks when compared with persons who received a low level of emotional support. Receipt of a high level of instrumental support was related to a higher risk of death (OR = 1.74, 95% CI 1.12-2.69). Interaction between disease status and social support or personal coping resources on mortality could not be demonstrated.
本研究聚焦于社会支持和个人应对资源在荷兰老年人死亡率方面所起的作用。数据来自于2829名年龄在55岁至85岁之间的非机构化人群样本,这些人在1992年至1995年参与了阿姆斯特丹纵向老龄化研究。社会支持从结构、功能和感知等方面进行操作性定义,个人应对资源包括掌控感、自我效能感和自尊的测量指标。死亡率数据平均是在29个月的随访期间获得的。考克斯比例风险回归模型显示,在控制了年龄、性别、慢性病、饮酒、吸烟、自评健康状况和功能受限等因素后,孤独感较少和掌控感较强与死亡率风险降低直接相关。此外,与获得低水平情感支持的人相比,获得中等水平情感支持的人(比值比(OR)=0.49,95%置信区间(CI)0.33 - 0.72)和获得高水平支持的人(OR = 0.68,95%CI 0.47 - 0.98)死亡率风险降低。获得高水平工具性支持与较高的死亡风险相关(OR = 1.74,95%CI 1.12 - 2.69)。未发现疾病状态与社会支持或个人应对资源在死亡率方面存在相互作用。