背景:低握力之间的联系,物理性能下降,老年人的不良健康结局已经得到了证实。然而,无法完成这些测试的老年人对残疾率和死亡率的影响在没有纵向研究的情况下仍未被探索.
方法:我们收集了中国健康与退休纵向研究(CHARLS)的数据。60-101岁的参与者在基线时登记。我们分析了无法完成握力(HGS)的人群的患病率,步态速度(GS),和五次椅台测试(FTCST)。使用完整的风险模型来估计7年内的死亡和残疾风险。
结果:总共3,768名参与者被纳入分析。无法完成GS和FTCST测试的老年人百分比随着年龄的增长而显著增加,从2.68到8.90%和2.60-20.42%,分别。无法执行HGS的老年人比例相对稳定,从1.40%到3.66%不等。与可以完成这些测试的老年人相比,那些不能进行FTCST的人面临着更高的死亡风险,风险高49.1%[风险比(HR)=1.491,95%CI=1.156,1.922;亚分布风险比(SHR)=1.491,95CI=1.135,1.958]。无法完成GS测试的参与者患ADL残疾的风险更高,无论他们是与表现最差的组(HR=1.411,95CI=1.037,1.920;SHR=1.356,95CI=1.030,1.785)还是能够完成GS的组(HR=1.727,95CI=1.302,2.292;SHR=1.541,95CI=1.196,1.986)进行比较.与表现最差的组(HR=0.982,95%CI=0.578,1.666;SHR=1.025,95%CI=0.639,1.642)或能够完成HGS测试(HR=1.008,95%CI=0.601,1.688;SHR=0.981,1.595%=)相比,无法完成HGS测试的老年人发生ADL残疾的风险无统计学显着差异。无法完成HGS测试的老年人与表现最差的老年人(HR=1.196,95CI=0.709-2.020;SHR=1.196,95CI=0.674,2.124)或能够完成测试的老年人(HR=1.462,95CI=0.872-2.450;SHR=1.462,95CI=0.821,2.605)的全因死亡率风险没有显着差异。
结论:无法完成测试的老年人面临的不良事件风险各不相同,表明未来研究对这一高危人群进行单独分析的必要性。
BACKGROUND: The link between low grip strength, diminished physical performance, and adverse health outcomes in older adults has been well-established. However, the impact of older adults who cannot complete these tests on disability and mortality rates remains unexplored without longitudinal study.
METHODS: We collected data from the
China Health and Retirement Longitudinal Study (CHARLS). Participants aged 60-101 were enrolled at baseline. We analyzed the prevalence of populations unable to complete handgrip strength (HGS), gait speed (GS), and five times chair stand test (FTCST). Completing risk models were used to estimate the risk of mortality and disability over seven years.
RESULTS: A total of 3,768 participants were included in the analysis. The percentage of older adults unable to complete the GS and FTCST tests increased notably with age, from 2.68 to 8.90% and 2.60-20.42%, respectively. The proportion of older people unable to perform the HGS was relatively stable, ranging from 1.40 to 3.66%. Compared to older adults who can complete these tests, those who cannot perform FTCST face a significantly higher risk of mortality, with 49.1% higher risk [hazard ratio (HR) = 1.491, 95% CI = 1.156, 1.922; subdistribution hazard ratio (SHR) = 1.491, 95%CI = 1.135,1.958)]. Participants who were unable to complete the GS test had a higher risk of developing ADL disability, regardless of whether they were compared to the lowest-performing group (HR = 1.411, 95%CI = 1.037,1.920; SHR = 1.356, 95%CI = 1.030,1.785) or those who can complete the GS (HR = 1.727, 95%CI = 1.302,2.292; SHR = 1.541, 95%CI = 1.196,1.986). No statistically significant difference in the risk of developing ADL disability among older adults who were unable to complete the HGS test compared with either the poorest performing group (HR = 0.982, 95% CI = 0.578, 1.666; SHR = 1.025, 95% CI = 0.639, 1.642) or those who were able to complete the HGS test (HR = 1.008, 95% CI = 0.601, 1.688; SHR = 0.981, 95% CI = 0.619, 1.553). The risk of all-cause mortality was not significantly different for older adults who were unable to complete the HGS test compared to those with the worst performance (HR = 1.196, 95%CI = 0.709-2.020; SHR = 1.196, 95%CI = 0.674, 2.124) or those who were able to complete the test (HR = 1.462, 95%CI = 0.872-2.450; SHR = 1.462, 95%CI = 0.821,2.605).
CONCLUSIONS: The risks of adverse events faced by older adults unable to complete the tests vary, indicating the necessity for future research to conduct separate analyses on this high-risk population.