Nakanishi N, Nishioka C, Yamada A, Kimoto K, Uzura S, Aoki Y, Yoneda H, Nagano K, Tatara K
Department of Public Health, Osaka University Medical School.
Nihon Koshu Eisei Zasshi. 1997 Nov;44(11):845-56.
To estimate the risk factors for intellectual dysfunction and examine its prognosis in a community-residing (non-institutionalized) elderly population, a randomly selected sample of 1,473 elderly people aged 65 years and over living in S city, Osaka Prefecture, was studied in October 1992, and data were obtained from 1,383, a response rate of 93.9%. A cohort of 1,383 was followed for 42 months and follow-up was completed for 1,300 (94.0%). The main results were as follows: 1) The prevalence of intellectual dysfunction did not differ significantly between sexes, and there was an increasing prevalence of intellectual dysfunction with age in both sexes. The prevalence of severe intellectual dysfunction was found to increase highly at age 85 and over. 2) By univariate analysis, odds ratios for age older than 75 years, low Activities of Daily Living (ADL), urinary and fecal incontinence, and no participation in social activities were significantly higher than 1 in any level of mild, moderate, and severe intellectual dysfunction. In the multivariate analysis using logistic regression, age older than 75 years and urinary and fecal incontinence showed significant higher odds ratios than 1 for severe intellectual dysfunction, and low ADL and treatment for hypertension also showed significant higher odds ratios than 1 for moderate intellectual dysfunction. 3) From analysis using the Kaplan-Meier method, the cumulative survival rates decreased with a decline in intellectual functioning in both age groups of 65-74 and 75 years and older. 4) Application of the Cox proportional hazards model resulted in adjusted hazard ratio for severe intellectual dysfunction of 1.79 (95% confidence interval, 1.02-3.12), controlling for other factors such as sex, age, general health status, incontinence and social activities.
为评估社区居住（非机构化）老年人群智力功能障碍的危险因素并研究其预后，1992年10月对大阪府S市随机抽取的1473名65岁及以上老年人进行了研究，最终获得1383人的数据，应答率为93.9%。对这1383人进行了42个月的随访，完成随访的有1300人（94.0%）。主要结果如下：1）智力功能障碍的患病率在性别间无显著差异，且男女患病率均随年龄增长而增加。发现85岁及以上重度智力功能障碍的患病率大幅上升。2）单因素分析显示，在任何轻度、中度和重度智力功能障碍水平下，75岁以上、日常生活活动能力（ADL）低下、大小便失禁以及不参加社交活动的比值比均显著高于1。在使用逻辑回归的多因素分析中，75岁以上以及大小便失禁对于重度智力功能障碍显示出显著高于1的比值比，ADL低下以及高血压治疗对于中度智力功能障碍也显示出显著高于1的比值比。3）通过使用Kaplan-Meier方法分析，65 - 74岁和75岁及以上两个年龄组的累积生存率均随智力功能下降而降低。4）应用Cox比例风险模型，在控制性别、年龄、总体健康状况、失禁和社交活动等其他因素后，重度智力功能障碍的调整后风险比为1.79（95%置信区间，1.02 - 3.12）。
