Agüero-Torres H, Fratiglioni L, Guo Z, Viitanen M, von Strauss E, Winblad B
Stockholm Gerontology Research Center, Karolinska Institute, Sweden.
Am J Public Health. 1998 Oct;88(10):1452-6. doi: 10.2105/ajph.88.10.1452.
The purpose of this investigation was to study the role of dementia and other common age-related diseases as determinants of dependence in activities of daily living (ADL) in the elderly.
The study population consisted of 1745 persons, aged 75 years and older, living in a district of Stockholm. They were examined at baseline and after a 3-year follow-up interval. Katz's index was used to measure functional status. Functional dependence at baseline, functional decline, and development of functional dependence at follow-up were examined in relation to sociodemographic characteristics and chronic conditions.
At baseline, factors associated with functional dependence were age, dementia, cerebrovascular disease, heart disease, and hip fracture. However, only age and dementia were associated with the development of functional dependence and decline after 3 years. In a similar analysis, including only nondemented subjects. Mini-Mental State Examination scores emerged as one of the strongest determinants. The population attributable risk percentage of dementia in the development of functional dependence was 49%.
In a very old population, dementia and cognitive impairment make the strongest contribution to both the development of long-term functional dependence and decline in function.
本研究旨在探讨痴呆及其他常见的老年相关疾病在老年人日常生活活动（ADL）依赖程度决定因素中所起的作用。
研究对象为居住在斯德哥尔摩某区的1745名75岁及以上的老年人。对他们进行了基线检查，并在3年随访期后再次检查。采用Katz指数来衡量功能状态。根据社会人口学特征和慢性疾病，对基线时的功能依赖、功能下降以及随访时功能依赖的发展情况进行了研究。
在基线时，与功能依赖相关的因素有年龄、痴呆、脑血管疾病、心脏病和髋部骨折。然而，3年后只有年龄和痴呆与功能依赖的发展及功能下降有关。在一项仅纳入非痴呆受试者的类似分析中，简易精神状态检查表得分成为最主要的决定因素之一。痴呆在功能依赖发展中的人群归因风险百分比为49%。
在高龄人群中，痴呆和认知障碍对长期功能依赖的发展及功能下降的影响最大。
