老年人5年死亡率的风险因素:心血管健康研究
L P Fried1, R A Kronmal, A B Newman
1Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Md, USA.
JAMA
|March 5, 1998
概括
亚临床疾病和功能限制显著预测老年人的死亡率. 疾病严重程度,脆弱性和残疾的客观测量是预测5年死亡风险的关键指标.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 内部医学 内部医学
背景情况:
- 老年人的死亡率是多因素的.
- 亚临床疾病对死亡风险的独立贡献尚未得到充分理解.
研究的目的:
- 确定疾病,功能和个人特征预测社区居住的老年人死亡率.
- 确定65岁及以上个体死亡率的联合预测因素.
主要方法:
- 基于人口的前性队列研究,随访5年.
- 非洲裔美国人的验证队列与4.25年的随访.
- 评估了5201名65岁以上 (原始) 和685名 (验证) 参与者的78个特征.
主要成果:
- 在5年内,主要队列中发生了646例死亡 (12%).
- 20个特征独立预测死亡率,包括年龄,男性性别,低收入,吸烟,高血压,高葡萄糖,低白蛋白,肺功能受损,心脏病和认知/功能缺陷.
- 客观的疾病测量比临床病史更强有力的预测因素,除了充血性心力衰竭.
结论:
- 亚临床疾病和疾病严重程度客观地预测老年人5年死亡率.
- 男性性别,贫困,身体不活动,吸烟,虚弱和残疾也是重要的预测因素.
- 与临床病史相比,定量疾病测量为死亡风险评估提供了更好的预测价值.
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