Honma Y, Kagamimori S, Nruse Y
Department of Community of Health, Toyama Medical and Pharmacological University.
Nihon Koshu Eisei Zasshi. 1998 Oct;45(10):1018-29.
The purpose of the present Study is to analyze the incidence of loss of active life and death rates over a 36 month period in elderly people living a home, to attempt to determine relationships of index of ADL for bed ridden elderly to incidence and expectancies of active life loss, for life and active life. The definition of loss of activities was as follows: Long term (over six months) medication at home, long term (over six months) admission to hospital or intermediate institute for elderly, admission to nursing home or death. Subjects were 6,883 people living at home in Ogi, Sage prefecture, aged 70 years or older. A total of 6,753 people could be followed up for thirty six months, with 287 people having long term medication at home, 389 people having long term admission in hospital or intermediate institute for elderly, 45 people were admission to nursing home and of these groups defined as experiencing, 490 people were died of all subjects, 746 deaths were observed. The main results were as follows: (1) Annual mortality rate was 5.4% for males, 3.0% for females, and annual rate of active life loss was 7.1% for males, 6.0% for females. Life expectancy for the 70-74 year group was 13.7 years for male, 17.9 years for female, and active life expectancy for the 70-74 year group was 12.0 year for males, 13.9 years for females. The difference between life expectancy and active life expectancy was 1.7 years for male, 4.2 years for female, which can be considered the average length of term requiring care. (2) From the relation between scale of active daily living for the handicapped elderly and the life expectancies of life and active life by Cox proportional hazard model analysis of survival, controlling for age and sex, five categories of classification for active daily living for a handicapped elderly were developed: 1-very healthy with abilities for using transportation (train and bus); 2-abilities of moving in the neighborhood by oneself; 3-abilities of moving in the neighborhood with help; 4-Chair-bound, 5-Bed-bound.
本研究的目的是分析居家老年人在36个月期间的失能发生率和死亡率，试图确定卧床老年人的日常生活活动（ADL）指数与失能发生率以及生命和活动生命预期之间的关系。失能的定义如下：在家长期（超过六个月）服药、长期（超过六个月）住院或入住老年中级机构、入住养老院或死亡。研究对象为佐贺县小城郡70岁及以上的6883名居家老人。共有6753人接受了36个月的随访，其中287人在家长期服药，389人长期住院或入住老年中级机构，45人入住养老院，在这些被定义为失能的人群中，所有研究对象中有490人死亡，共观察到746例死亡。主要结果如下：（1）男性年死亡率为5.4%，女性为3.0%，男性年失能率为7.1%，女性为6.0%。70 - 74岁组男性的预期寿命为13.7年，女性为17.9年，70 - 74岁组男性的活动生命预期为12.0年，女性为13.9年。男性预期寿命与活动生命预期的差值为1.7年，女性为4.2年，这可被视为平均护理期限。（2）通过对生存情况进行Cox比例风险模型分析，在控制年龄和性别的情况下，根据残疾老年人的日常生活活动量表与生命和活动生命预期之间的关系，制定了残疾老年人日常生活活动的五类分类：1 - 非常健康，具备使用交通工具（火车和公交车）的能力；2 - 能够独自在邻里间活动；3 - 在他人帮助下能够在邻里间活动；4 - 需借助轮椅；5 - 卧床不起。
