Freedman V A, Martin L G
Labor and Population Program, RAND, Washington, DC 20005, USA.
Am J Public Health. 1998 Oct;88(10):1457-62. doi: 10.2105/ajph.88.10.1457.
This report documents trends in functional limitations among older Americans from 1984 to 1993 and investigates reasons for such trends.
We applied logistic regression to data for noninstitutionalized Americans aged 50 years and older from the Survey of Income and Program Participation. We focused on 4 functional limitation measures unlikely to be affected by changes in role expectations and living environments: reported difficulty seeing words in a newspaper, lifting and carrying 10 pounds, climbing a flight of stairs, and walking a quarter of a mile.
We found large declines in the crude prevalence of functional limitations, especially for those 80 years and older. Generally, changes in population composition explained only a small portion of the downward trends. Once changes in population composition and mobility-related device use were considered for difficulty walking, significant improvements in functioning remained for the 65- to 79-year-old group.
Changes in population composition, device use, survey design, role expectations, and living environments do not appear to account completely for improvements in functioning. We infer that changes in under-lying physiological capability--whether real or perceived--likely underlie such trends.
本报告记录了1984年至1993年美国老年人功能受限情况的趋势，并调查了出现这些趋势的原因。
我们对收入与项目参与调查中50岁及以上非机构化美国人的数据进行了逻辑回归分析。我们重点关注4项不太可能受角色期望和生活环境变化影响的功能受限指标：报告在看报纸上的字时有困难、提起并搬运10磅重物、爬一段楼梯以及步行四分之一英里。
我们发现功能受限的粗患病率大幅下降，尤其是80岁及以上的人群。总体而言，人口构成的变化仅解释了下降趋势的一小部分。一旦考虑了人口构成和与行动相关设备使用的变化对行走困难的影响，65至79岁年龄组的功能仍有显著改善。
人口构成、设备使用、调查设计、角色期望和生活环境的变化似乎并不能完全解释功能的改善情况。我们推断，潜在生理能力的变化——无论真实与否——可能是这些趋势的根本原因。
