Observation on survival of the elderly by the severity of impaired activity of daily life and causes of death

老年人日常生活活动能力受损严重程度及死亡原因的生存观察

基本信息

批准号：
12672190
负责人：
UEDA Kazuo
金额：
$ 2.18万
依托单位：
KYUSHU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12672190/
关键词：
activity of daily life quality of life JACCDC cohort elderly population Barthel index prognosis of life

项目摘要

Life expectancy of the elderly for the Japanese is growing year by year, and in consequence Japan runs up to the top ranking of longevity in the world. Geriatric society estimated only by life expectancy, however, is not necessarily mature, and one of factors to inhibit the completeness of fully ripe geriatric society is impaired activity of daily life (ADL) of the elderly.The Japanese Association for Cerebro-cardiovascular Disease Control (JACCDC) has studied actual figures of impaired ADL including 6,000 〜 13,000 subjects aged 65 or over extracted from 10 to 12 areas throughout Japan from 1996 to 1997. Based on the data we estimated quantitatively the severity of impaired ADL of the elderly by Barthel index in 1998. In this study we have followed up 1,492 elderly subjects (11.5 % of JACCDC cohort) with impaired ADL for three years from 1998 to 2001, and obtained data on survival aimed at elucidating an influence of impaired ADL on victim's outcome. During three years of follow-up 130 elderly died (9 %). We classified the severity of impaired ADL into three groups, namely, severe (A group, A・G), moderate (B group, B・G) and slight (C group, C・G), and compared survived rates (Kaplan-Miere) among three groups. Survival most decreased in A・G followed by order of B・G and C・G. We have corrected survived rates by the state of medical treatment and aid-assistance during the follow-up using Cox's proportional hazard model. The impaired ADL most affected survival even though these parameters were taken into account.After adjustment relative risk of dead for A・G and B・G to C・G was 2.6 and 1.9 in each (p<0.01).In conclusion, the severe impaired ADL was, the poorer prognosis of life of the elderly was observed without any relation to medical treatment and aid-care.Since cerebral stroke mostly gave an influence on the severity of impaired ADL for the elderly, preventive strategy of cerebral stroke seems to be most effective on making healthy geriatric society.

日本人对年轻人的预期寿命逐年增长，因此日本在世界上寿命最高。然而，仅根据预期寿命估算的老年社会并不是必需的成熟，并且抑制完全成熟的老年社会完整性的因素之一是老年人的日常生活活动（ADL）受损。日本的脑血管血管疾病控制协会（JACCDC）遍布105,000个地区，包括ADL的实际数字，包括ADL的13,000个摄入量。从1996年到1997年。根据数据，我们在1998年由Barthel指数估算了数量，而Barthel指数的ADL受损的严重程度。在这项研究中，我们对1,492名受试者（JACCDC共同的11.5％）与ADL的ADL相比，从1998年到2001年，对ADL的ADL进行了三年的损害，并在2001年中获得了对远离生存的数据的影响。在三年后续行动中，130本基本死亡（9％）。我们将受损的ADL的严重程度分为三组，即严重（一组，A g），中度（B组，B g）和轻微（C组，C g），并比较了三组中的存活率（Kaplan-Miere）。生存率最大，在a g和c c・g中最大的降低。在随访期间，使用Cox的比例危害模型，我们通过医疗和辅助辅助状态纠正了生存率。即使考虑了这些参数，ADL也受到影响最大的生存最大。对于年龄较大的脑卒中预防策略的ADL受损似乎是使健康的老年社会最有效的。