肥胖和残疾之间不断变化的关系,1988-2004年
Dawn E Alley1, Virginia W Chang
1Robert Wood Johnson Health and Society Scholars Program, University of Pennsylvania, Philadelphia, PA 19104-6218, USA. alley@wharton.upenn.edu
JAMA
|November 8, 2007
概括
肥胖与老年人功能障碍的增加有关,随着时间的推移,风险会增加. 尽管心血管系统有所改善,但肥胖与老年人残疾减少没有相关性.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 自20世纪60年代以来,肥胖患病率上升,但心血管风险因素和死亡率在肥胖人口中下降.
- 这些趋势对老年人残疾风险的影响尚不清楚.
- 在肥胖的老年人中,尽管健康标志物有所改善,但残疾增加的可能性仍然存在.
研究的目的:
- 研究随着时间的推移,肥胖和残疾之间的关系的变化.
- 评估肥胖个体心血管健康的改善是否转化为减少残疾.
主要方法:
- 分析了国家健康和营养检查调查 (NHANES) 的两个波 (1988-1994年和1999-2004年).
- 包括9,928名60岁及以上的成年人,测量身体质量指数.
- 通过功能限制和日常生活活动 (ADL) 障碍来评估残疾.
主要成果:
- 在两次调查期间,肥胖个体的功能障碍患病率显著增加 (5.4%).
- 在1988-1994年和1999-2004年期间,肥胖个体的功能障碍的几率从1.78增加到2.75.
- 虽然非肥胖个体的ADL损伤有所减少,但肥胖个体没有经历类似的改善,在1999-2004年间,其几率显著增加.
结论:
- 在肥胖的老年人中,心血管健康的改善并没有导致残疾减少.
- 肥胖的老年人在调查后期更有可能出现功能障碍.
- 与肥胖相关的死亡率下降和肥胖早期发病可能会导致肥胖人口老龄化中的残疾负担日益增加.
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