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年龄与残疾发病时的严重程度与全因死亡率之间的关联:从健康与退休研究的长度观察研究
Anying Bai1, Cuie Liu2, Yu Jiang1,3
1School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
JMIR aging
|October 3, 2025
概括
早期的残疾发作,特别是55岁之前,显著增加了死亡风险. 严重的残疾和男性性别进一步增加了这种风险,突出了针对性干预的必要性.
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:
- 残疾是一个日益严重的全球公共卫生问题,不成比例地影响着老年人.
- 残疾严重影响健康状况,增加死亡率.
研究的目的:
- 调查残疾发病的年龄和严重程度与全因死亡率之间的关联.
- 分析生活在社区中的成年人新发性日常生活活动 (ADL) 和日常生活工具活动 (IADL) 障碍的死亡风险.
主要方法:
- 来自美国51岁或以上的成年人健康与退休研究 (波段10-16,2010-2023) 的纵向数据的分析.
- 对没有ADL/IADL残疾的参与者进行随访,对新发病例进行匹配的对照.
- 利用多变量Cox比例危险模型来评估死亡风险,按年龄和残疾严重程度分层.
主要成果:
- 超过8.58年的中位数随访,37.98%的ADL和43%的IADL残疾人死亡.
- 在55岁之前开始的残疾显示出最高的死亡风险 (HR 3.12),随着严重程度的增加 (HR 4.07).
- 死亡风险与发病时的年龄相反相关,男性比女性更高.
结论:
- 早期发病和严重残疾是所有原因死亡率增加的重要预测因素.
- 男人面临着不成比例地更高的残疾发病死亡风险.
- 针对早期和严重残疾的预防策略,考虑到性别差异,对于改善长期生存至关重要.
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