人生の終わりに機能的衰退のパターン
June R Lunney1, Joanne Lynn, Daniel J Foley
1Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Md 20892-9205, USA. june_lunney@nih.gov
JAMA
|May 15, 2003
まとめ
終末期における機能的衰退は,疾患経路によって著しく異なります. 脆弱性や臓器不全が最も減少し,突然死が最も減少し,介護の必要性に影響を及ぼしている.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
背景:
- 臨床医は,終末期ケアにおいて,様々な機能的衰弱パターンを観察しています.
- 大集団におけるこれらのパターンに関する経験的データは限られている.
研究 の 目的:
- 4つの異なる終末期疾患経路における機能的衰退の違いを調査する.
- これらの経路には,突然死,癌死,臓器不全による死,および弱さが含まれます.
主な方法:
- 高齢者の流行病学研究のための確立された集団 (EPESE) 研究のコホート分析.
- 4,190人の死亡前の1年以内に自己または代理人の報告した身体機能 (Activities of Daily Living - ADLs) を検査した.
- 病気経路におけるADL依存度を比較し,人口統計的要因を考慮した.
主要な成果:
- 4つの疾患経路において,機能的衰退の有意な変動が観察されました.
- 突然死亡の死者は高い機能を維持し,弱い死者は最も依存を示しました.
- 癌や臓器不全で亡くなった人は,衰退の中間パターンを示し,死亡に近づくにつれて障害が増加しました.
結論:
- 寿命の終わりの機能的衰退の軌道は非常に変動します.
- これらの明確なパターンを特定することは,個別化されたケア戦略を開発し,終末期プログラムを改善するために不可欠です.
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