背景:世界卫生组织将健康衰老定义为随着衰老而维持功能能力。内在能力是衡量健康老龄化的指标,可以由社会决定因素塑造。然而,对多种社会决定因素如何影响内在能力的总体理解仍不清楚。我们旨在总结观察性研究,调查社区居住的成年人之间社会决定因素与内在能力的关系。
方法:通过Medline进行了系统搜索,Embase,PsycInfo,WebofScience,和CINAHL至2023年8月14日。
结果:在查看了813篇文章之后,我们纳入了来自亚洲9个国家的21项研究,欧洲,和美国。17项研究使用横截面设计,其他研究为纵向研究。与内在能力相关的社会决定因素可以分为五个领域,包含社会经济地位(16,76.2%的研究),生活方式(14,66.7%),社会心理因素(9,42.9%),材料情况(4,19.0%),和医疗保健系统(1.4.8%)。强有力的证据支持更好的内在能力与高等教育有关,更高的财富,更多的体育活动,禁止吸烟,更多的社会参与,结婚或成为伴侣.在研究中,内在能力与饮食模式和饮酒的关系是矛盾的。关于工作状态协会的研究,住房环境,具有内在能力的医疗保健可及性不足以得出结论。
结论:这些发现突出了社会经济地位的作用,生活方式,和提高内在能力从而促进健康老龄化的社会心理因素。未来的研究需要调查社会决定因素和内在能力之间的因果关系,特别是物质环境和医疗保健系统。
The World Health Organization defined healthy ageing as the maintenance of functional ability with ageing. Intrinsic capacity is a measurement of healthy ageing, and can be shaped by social determinants. However, an overall understanding of how multiple social determinants contribute to intrinsic capacity remains unclear. We aim to summarize observational studies investigating the relationships between social determinants and intrinsic capacity among community-dwelling adults.
A systematic search was conducted through Medline, Embase, PsycInfo, Web of Science, and CINAHL until August 14, 2023.
After reviewing 813 articles, we included 21 studies from nine countries in Asia, Europe, and America. Seventeen studies used a cross-sectional design and the others were longitudinal studies. Social determinants related to intrinsic capacity can be classified into five domains, containing socioeconomic status (16, 76.2% of studies), lifestyles (14, 66.7%), psychosocial factors (9, 42.9%), material circumstances (4, 19.0%), and healthcare systems (1, 4.8%). Strong evidence supported that better intrinsic capacity was associated with higher education, higher wealth, more physical activities, no smoking, more social engagement, and being married or partnered. The relationships of intrinsic capacity with dietary patterns and alcohol drinking were contradictory across studies. Research on the associations of working status, housing environments, and healthcare accessibility with intrinsic capacity was insufficient to draw conclusions.
These findings highlight roles of socioeconomic status, lifestyles, and psychosocial factors in improving intrinsic capacity thus promoting healthy ageing. Future research is needed to investigate causal relationships between social determinants and intrinsic capacity, especially material circumstances and healthcare systems.