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  • 1.

    【2hr】The transition to living alone and psychological distress in later life

    包量

    机译 向独居的过渡和晚年的心理困扰
    摘要：>Background: living alone in later life has been linked to psychological distress but less is known about the role of the transition into living alone and the role of social and material resources.>Methods: a total of 21,535 person-years of data from 4,587 participants of the British Household Panel Survey aged 65+ are analysed. Participants provide a maximum 6 years' data (t0−t5), with trajectories of living arrangements classified as: consistently partnered/ with children/alone; transition from partnered to alone/with children to alone. General Health Questionnaire (GHQ)-12 caseness (score >3) is investigated using multi-level logistic regression, controlling for sex, age, activities of daily living, social and material resources.>Results: after a transition from partnered at t0 to alone at t1, the odds for GHQ-12 caseness increased substantially, but by t3 returned to baseline levels. The odds for caseness at t0 were highest for those changing from living with a child at t0 to living alone at t1 but declined following the transition to living alone. None of the covariates explained these associations. Living consistently alone did confer increased odds for caseness.>Conclusions: living alone in later life is not in itself a strong risk factor for psychological distress. The effects of transitions to living alone are dependent on the preceding living arrangement and are independent of social and material resources. This advocates a longitudinal approach, allowing identification of respondents' location along trajectories of living arrangements.
  • 2.

    【2hr】Exploring the relationship between national economic indicators and relative fitness and frailty in middle-aged and older Europeans

    包量

    机译 探索国民经济指标与中老年人之间的相对体质和虚弱之间的关系
    摘要：>Background: on an individual level, lower-income has been associated with disability, morbidity and death. On a population level, the relationship of economic indicators with health is unclear.>Objective: the purpose of this study was to evaluate relative fitness and frailty in relation to national income and healthcare spending, and their relationship with mortality.>Design and setting: secondary analysis of data from the Survey of Health, Ageing and Retirement in Europe (SHARE); a longitudinal population-based survey which began in 2004.>Subjects: a total of 36,306 community-dwelling people aged 50 and older (16,467 men; 19,839 women) from the 15 countries which participated in the SHARE comprised the study sample. A frailty index was constructed as the proportion of deficits present in relation to the 70 deficits available in SHARE. The characteristics of the frailty index examined were mean, prevalence of frailty and proportion of the fittest group.>Results: the mean value of the frailty index was lower in higher-income countries (0.16 ± 0.12) than in lower-income countries (0.20 ± 0.14); the overall mean frailty index was negatively correlated with both gross domestic product (r = −0.79; P < 0.01) and health expenditure (r = −0.63; P < 0.05). Survival in non-frail participants at 24 months was not associated with national income (P = 0.19), whereas survival in frail people was greater in higher-income countries (P < 0.05).>Conclusions: a country's level of frailty and fitness in adults aged 50+ years is strongly correlated with national economic indicators. In higher-income countries, not only is the prevalence of frailty lower, but frail people also live longer.
  • 3.

    【2hr】Tumour necrosis factor receptor 1 and mortality in a multi-ethnic cohort: the Northern Manhattan Study

    包量

    机译 肿瘤坏死因子受体1与多族裔人群的死亡率：北曼哈顿研究
    摘要：>Objective: to study the association between soluble tumour necrosis factor receptor 1 (sTNFR1) levels and mortality in the population-based Northern Manhattan Study (NOMAS).>Methods: NOMAS is a multi-ethnic, community-based cohort study with mean 8.4 years of follow-up. sTNFR1 was measured using ELISA. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals (HR, 95% CI) for the association of sTNFR1 with risk of all-cause mortality after adjusting for relevant confounders.>Results: sTNFR1 measurements were available in 1,862 participants (mean age 69.2 ± 10.2 years) with 512 all-cause deaths. Median sTNFR1 was 2.28 ng/ml. Those with sTNFR1 levels in the highest quartile (Q4), compared with those with sTNFR1 in the lowest quartile (Q1), were at an increased risk of all-cause mortality (adjusted HR: 1.8, 95% CI: 1.4–2.4) and non-vascular mortality (adjusted HR: 2.5, 95% CI: 1.5–3.6), but not vascular mortality (adjusted HR: 1.3, 95% CI: 0.9–1.9). There were interactions between sTNFR1 quartiles and medical insurance-status [likelihood ratio test (LRT) with 3 degrees of freedom, Pinteraction = 0.02] and alcohol consumption (LRT with 3 degrees of freedom, Pinteraction < 0.01) for all-cause mortality. In participants with no insurance or Medicaid, those with sTNFR1 in the top quartile had nearly a threefold increased risk of total mortality than the lowest quartile (adjusted HR: 2.9, 95% CI: 1.9–4.4).>Conclusion: in this multi-ethnic cohort, sTNFR1 was associated with all-cause and non-vascular mortality, particularly among those of a lower socioeconomic status.
  • 4.

    【2hr】The role of physical activity and diabetes status as a moderator: functional disability among older Mexican Americans

    包量

    机译 体育活动和糖尿病状态作为调节者的作用：墨西哥裔美国人中的功能障碍
    摘要：>Purpose: we investigate the temporal association between the rate of change in physical function and the rate of change in disability across four comparison groups: Those with and without diabetes who report >30 min of physical activity per day, and those who report <30 min of physical activity per day.>Methods: six waves of longitudinal data from the Hispanic Established Population for Epidemiologic Studies of the Elderly were utilised. At baseline, there were a total of 3,050 elder participants aged 65 years old or greater. The longitudinal rates of change in disability and physical function were compared by the diabetes status (ever versus none) and the physical activity status (less than or greater than or equal to 30 min per day).>Results: disability and physical function data were analysed using a latent growth curve modelling approach adjusted for relevant demographic/health-related covariates. There were statistically significant longitudinal declines in physical function and disability (P < 0.001) in all groups. Most notable, the physical activity status was an important moderator. Those with >30 min of activity demonstrated better baseline function and less disability as well as better temporal trajectories than those reporting <30 min of physical activity per day. Comparisons between diabetes statuses within the same physical activity groups showed worse disability trajectories among those with diabetes.>Conclusions: a longitudinal decline in physical function and disability is moderated most notably by physical activity. The diabetes status further moderates decline in function and disability over time. Increased physical activity appears to be protective of disability in general and may lessen the influence of diabetes-related disability in older Mexican Americans, particularly at the end of life.
  • 5.

    【2hr】Older adults with higher income or marriage have longer telomeres

    包量

    机译 收入较高或结婚的老年人端粒更长
    摘要：>Background: telomere length has been used to represent biological ageing and is found to be associated with various physiological, psychological and social factors.>Objective: to explore the effects of income and marriage on leucocyte telomere length in a representative sample of older adults.>Design and subjects: cross-sectional analysis among 298 adults, aged 65–74, randomly selected from the community by census.>Methods: telomere length was measured by quantitative PCR. Participants provided information on sociodemographics, physical illness and completed questionnaires rating mental state and perceived neighbourhood experience.>Results: telomere length was negatively associated with lower income [coefficient −0.141 (95% CI: −0.244 to −0.020), P = 0.021] and positively associated with the marital status [coefficient 0.111 (95% CI: −0.008 to 0.234), P = 0.067] when controlling for gender, age, educational level, physical diseases (including diabetes, hypertension, cardiovascular diseases, cerebrovascular disease and Parkinson's disease), depressive symptoms, minor mental symptoms, cognitive impairment and perceived neighbourhood experience (including social support, perceived security and public facilities).>Conclusions: these results indicate that older adults with higher income or being married have longer telomeres when other sociodemographics, physical diseases, mental status and neighbourhood experience are adjusted.
  • 6.

    【2hr】Cognitive screening in the acute stroke setting

    包量

    机译 急性中风背景下的认知筛查
    摘要：>Background: current literature suggests that two-thirds of patients will have cognitive impairment at 3 months post-stroke. Post-stroke cognitive impairment is associated with impaired function and increased mortality. UK guidelines recommend all patients with stroke have a cognitive assessment within 6 weeks. There is no ‘gold standard’ cognitive screening tool. The Montreal cognitive assessment (MoCA) is more sensitive than the Mini-Mental State Examination (MMSE) in mild cognitive impairment and for cognitive impairment in the non-acute post-stroke setting and in a Chinese-speaking acute stroke setting.>Methods: a convenience sample of 50 patients, admitted with stroke or transient ischaemic attack (TIA), were screened within 14 days, using the MoCA and the MMSE.>Results: the mean MoCA was 21.80 versus a mean MMSE of 26.98; 70% were impaired on the MoCA (cut-off <26) versus 26% on MMSE (cut-off <27). The MoCA could be completed in <10 min in 90% of cases.>Conclusion: the MoCA is easy and quick to use in the acute stroke setting. Further work is required to determine whether a low score on the MoCA in the acute stroke setting will predict the cognitive and functional status and to explore what the best cut-off should be in an acute post-stroke setting.
  • 7.

    【2hr】Adult macronutrient intake and physical capability in the MRC National Survey of Health and Development

    包量

    机译 MRC国家健康与发展调查中的成人大量营养素摄入量和身体机能
    摘要：>Background: poor physical capability is associated with higher subsequent risk of disability and mortality in older people. Energy and macronutrient intakes may play a role in the maintenance of physical capability. This analysis aimed to examine the role of intakes of energy and the macronutrients, protein, carbohydrate and fat in early and mid-adulthood on objective measures of physical capability in later adulthood in the MRC National Survey of Health and Development (1946 British birth cohort).>Methods: adult diet assessed by a 5-day diary at 36 years (1982) and 43 years (1989). Physical capability was assessed at 53 years. Objective measures were height, weight and three measures of physical capability: grip strength, standing balance time and chair rises.>Results: using multiple linear regression analysis, modest positive associations were found between energy intake at 36 and 43 years and grip strength at 53 years. Results for macronutrients were mixed although there was some indication of relationships of protein intake with grip strength and standing balance time.>Conclusions: higher energy intake in midlife may play a role in the prevention of muscle weakness in later life. Higher protein intakes may also be related to physical capability but further research is needed.
  • 8.

    【2hr】Socioeconomic circumstances health behaviours and functional limitations in older persons in four Central and Eastern European populations

    包量

    机译 中欧和东欧四个人口的老年人的社会经济状况健康行为和功能限制
    摘要：>Objectives: to investigate functional limitations and their association with socioeconomic factors in four Central and Eastern European populations.>Methods: a cross-sectional study of random population samples in Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania) and six Czech towns participating in the HAPIEE study. Functional limitations (classified into tertiles of the SF-36 physical functioning subscale), socioeconomic circumstances and health behaviours were available for 34,431 subjects aged 45–69 years.>Results: the proportion of subjects in the worst tertile of the functional limitations score (≤80% of the maximum score) ranged from 21% of the men in Kaunas to 48% in Krakow women. In multivariate ordered logistic regression, functional limitations were strongly inversely associated with education and positively with material deprivation and with being economically inactive. Functional limitations were more common in male smokers and less common in alcohol drinkers. Socioeconomic characteristics explained some of the differences in functional limitations between populations. Health behaviours explained some of the differences between social groups in both genders and between populations in women.>Conclusion: unexpectedly, functional limitations were not most common in the sample from Russia, the country with the highest mortality rates. All socioeconomic measures were strongly associated with functional limitations and made some contribution towards explaining differences in limitations between populations.
  • 9.

    【2hr】Community falls prevention for people who call an emergency ambulance after a fall: an economic evaluation alongside a randomised controlled trial

    包量

    机译 跌倒后呼叫紧急救护车的人的社区跌倒预防：经济评估和随机对照试验
    摘要：>Objective: we estimated the cost-effectiveness of a community falls prevention service compared with usual care from a National Health Service and personal social services perspective over the 12 month trial period.>Design: a cost-effectiveness and cost utility analysis alongside a randomised controlled trial>Setting: community.>Participants: people over 60 years of age living at home or in residential care who had fallen and called an emergency ambulance but were not taken to hospital.>Interventions: referral to community fall prevention services or usual health and social care.>Measurements: incremental cost per fall prevented and incremental cost per Quality-Adjusted Life Years (QALYs)>Results: a total of 157 participants (82 interventions and 75 controls) were used to perform the economic evaluation. The mean difference in NHS and personal social service costs between the groups was £-1,551 per patient over 1 year (95% CI: £-5,932 to £2,829) comparing the intervention and control groups. The intervention patients experienced on average 5.34 fewer falls over 12 months (95% CI: −7.06 to −3.62). The mean difference in QALYs was 0.070 (95% CI: −0.010 to 0.150) in favour of the intervention group.>Conclusion: the community falls prevention service was estimated to be cost-effective in this high-risk group. Current Controlled Trials ISRCTN67535605. (controlled-trials.com)
  • 10.

    【2hr】Childhood milk consumption is associated with better physical performance in old age

    包量

    机译 童年时期食用牛奶与老年人更好的身体机能相关
    摘要：>Background: studies have shown that milk and dairy consumption in adulthood have beneficial effects on health.>Methods: we examined the impact of childhood and adult diet on physical performance at age 63–86 years. The Boyd Orr cohort (n = 405) is a 65-year prospective study of children who took part in a 1930's survey; the Caerphilly Prospective Study (CaPS; n = 1,195) provides data from mid-life to old age. We hypothesised that higher intakes of childhood and adult milk, calcium, protein, fat and energy would be associated with a better performance.>Results: in fully adjusted models, a standard deviation (SD) increase in natural log-transformed childhood milk intake was associated with 5% faster walking times from the get-up and go test in Boyd Orr (95% CI: 1 to 9) and 25% lower odds of poor balance (OR: 0.75; 0.55 to 1.02). Childhood calcium intake was positively associated with walking times (4% faster per SD; 0 to 8) and a higher protein intake was associated with lower odds of poor balance (OR: 0.71; 0.54 to 0.92). In adulthood, protein intake was positively associated with walking times (2% faster per SD; 1 to 3; Boyd Orr and CaPS pooled data).>Conclusion: this is the first study to show positive associations of childhood milk intake with physical performance in old age.
  • 11.

    【2hr】The impact of visual impairment on Mini-Mental State Examination Scores in the Newcastle 85+ study

    包量

    机译 纽卡斯尔85+研究中视力障碍对小精神状态考试成绩的影响
    摘要：>Background: cognitive test scores and visual acuity are strongly associated in older people. This may be due to poor vision limiting performance on cognitive tasks specifically requiring vision, or an association between visual and neurodegenerative disorders.>Objective: to explore, using data from the Newcastle 85+ cohort study, the impact of sight impairment (SI) on Mini-Mental State Examination (MMSE) scores and whether reduced scores among SI participants are limited to tasks requiring vision.>Results: of 839 participants aged 85 years, 44 (5.2%) were registered SI. Median (inter-quartile range) sMMSE scores were 25 (22–29) for SI and 28 (25–29) for non-SI participants (P = 0.006). SI participants had lower subscale scores on tasks requiring vision (P < 0.001 for each) but also for some subscale scores not obviously requiring vision: orientation (P = 0.018) and repetition (P = 0.030). Excluding visual items, there was no significant difference in MMSE scores between those with/without SI.>Conclusion: SI may be an obstacle to older people completing cognitive assessments including tasks requiring vision. People with SI also scored lower on some tasks not obviously requiring vision. An association between cognitive impairment and SI may exist beyond simply being unable to see the test material in cognitive tests.
  • 12.

    【2hr】Interpreting and evaluating the CASP-19 quality of life measure in older people

    包量

    机译 解释和评估老年人的CASP-19生活质量测量
    • 作者：Denise Howel
    • 刊名：Age and ageing
    • -1年第5期
    摘要：>Objective: to investigate how to interpret changes on the CASP-19 quality of life scale for older people, and whether it discriminates between, and is responsive to, relevant differences or changes in participants' circumstances.>Methods: analysis of data from the English Longitudinal Study of Ageing for those completing CASP-19 in both Wave 1 and Wave 2 (n = 6,482). Cross-sectional and longitudinal comparisons, using multiple linear regression, of CASP-19 scores with respect to eight anchor variables.>Results: cross-sectional comparisons found differences in mean CASP-19 scores at Wave 1 between categories of anchor variables varied from 1.9 for living alone to 8.0 for being able to walk ¼ mile with difficulty. Longitudinal comparisons of changes in CASP-19 found that subjects that had moved between categories of the anchor variables over 28 months, had changed their mean CASP-19 score by about 1 unit in the expected direction, compared with the unchanged category. These changes were statistically significant for six of the eight anchors.>Conclusions: the cross-sectional comparisons help interpret differences and indicate CASP-19 has discriminatory power. The longitudinal changes show that CASP-19 is responsive to changes in most anchor variables that reflect some aspects of quality of life.
  • 13.

    【2hr】Older peoples preferences regarding programme formats for managing concerns about falls

    包量

    机译 老年人对计划格式的偏好以管理对跌倒的担忧
    摘要：>Objective: to explore the preferences of community-dwelling older persons regarding different programme formats for managing concerns about falls.>Subjects and design: cross-sectional study of 5,755 community-dwelling people aged ≥70 years in the Netherlands.>Methods: a questionnaire assessed people's willingness to participate per programme format (n = 6), i.e. a programme at home, via telephone, via home visits and telephone consultations, via television or via Internet.>Results: of the 2,498 responders, 62.7% indicated no interest in any of the formats. The willingness to participate per programme format varied between 21.5 (at home) and 9.4% (via Internet). Among people interested in at least one of the formats (n = 931), higher levels of fall-related concerns were associated with increased preference for a programme with home visits. Poor perceived health and age ≥80 years were associated with less preference for a group programme. Higher educated people were more in favour of a programme via Internet compared with their lower educated counterparts.>Conclusion: the majority of community-dwelling older people are not likely to participate in any of the six proposed programme formats for managing concerns about falls. However, when diverse formats of effective programmes will be made available, uptake and adherence may be increased since programme preferences are associated to specific population characteristics.
  • 14.

    【2hr】Effect of vertebral fractures on function quality of life and hospitalisation the AGES-Reykjavik study

    包量

    机译 椎骨骨折对AGES-雷克雅未克研究的功能生活质量和住院治疗的影响
    摘要：>Background: understanding the determinants of health burden after a fracture in ageing populations is important.>Objective: assess the effect of clinical vertebral and other osteoporotic fractures on function and the subsequent risk of hospitalisation.>Design: individuals from the prospective population-based cohort study Age, Gene/Environment Susceptibility (AGES)-Reykjavik study were examined between 2002 and 2006 and followed up for 5.4 years.>Subjects: a total of 5,764 individuals, 57.7% women, born 1907–35, mean age 77.>Method: four groups with a verified fracture status were used; vertebral fractures, other osteoporotic fractures excluding vertebral, non-osteoporotic fractures and not-fractured were compared and analysed for the effect on mobility, strength, QoL, ADL, co-morbidity and hospitalisation.>Results: worst performance on functional tests was in the vertebral fracture group for women (P < 0.0001) and the other osteoporotic fractures group for men (P < 0.05). Both vertebral and other osteoporotic fractures, showed an increased risk of hospitalisation, HR = 1.4 (95% CI: 1.3–1.7) and 1.2 (95% CI: 1.1–1.2) respectively (P < 0.0001). Individuals with vertebral fractures had 50% (P < 0.0001) longer hospitalisation than not-fractured and 33% (P < 0.002) longer than the other osteoporotic fractures group.>Conclusion: individuals with a history of clinical vertebral fracture seem to carry the greatest health burden compared with other fracture groups, emphasising the attention which should be given to those individuals.
  • 15.

    【2hr】Inferior physical performance test results of 10998 men in the MrOS Study is associated with high fracture risk

    包量

    机译 MrOS研究中10998名男性的体能测试结果较差与骨折风险高相关
    摘要：>Background: most fractures are preceded by falls.>Objective: the aim of this study was to determine whether tests of physical performance are associated with fractures.>Subjects: a total of 10,998 men aged 65 years or above were recruited.>Methods: questionnaires evaluated falls sustained 12 months before administration of the grip strength test, the timed stand test, the six-metre walk test and the twenty-centimetre narrow walk test. Means with 95% confidence interval (95% CI) are reported. P < 0.05 is a statistically significant difference.>Results: fallers with a fracture performed worse than non-fallers on all tests (all P < 0.001). Fallers with a fracture performed worse than fallers with no fractures both on the right-hand-grip strength test and on the six-metre walk test (P < 0.001). A score below –2 standard deviations in the right-hand-grip strength test was associated with an odds ratio of 3.9 (95% CI: 2.1–7.4) for having had a fall with a fracture compared with having had no fall and with an odds ratio of 2.6 (95% CI: 1.3–5.2) for having had a fall with a fracture compared with having had a fall with no fracture.>Conclusion: the right-hand-grip strength test and the six-metre walk test performed by old men help discriminate fallers with a fracture from both fallers with no fracture and non-fallers.
  • 16.

    【2hr】Brief Memory and Executive Test: evaluation of a new screening test for cognitive impairment due to small vessel disease

    包量

    机译 简短的记忆力和执行力测试：评估新的筛查测试以检查由于小血管疾病引起的认知障碍
    摘要：>Background: cerebral small vessel disease (SVD) is the most common cause of vascular cognitive impairment (VCI). Despite this, there is a paucity of rapid simple screening tools to identify cognitive impairment in SVD and differentiate it from other common dementia types.>Objective: to validate a new screening test for cognitive impairment in SVD, the Brief Memory and Executive Test (BMET) battery, and examine its ability to detect SVD and differentiate it from Alzheimer's disease (AD).>Subjects: 45 patients with SVD, 27 patients with AD and 80 normal controls.>Methods: the BMET includes brief tests of executive functioning and processing speed, with comparative tests of memory and orientation. Group discrimination was calculated using discriminant function analysis.>Results: the BMET took an average of 10 min to administer. It showed high sensitivity (91%) and specificity (85%) in differentiating SVD patients with cognitive impairment from AD patients. As a comparison the mini-mental state examination had lower sensitivity (63%) and specificity (62%).>Conclusions: the BMET is a simple and quick to administer clinical tool for the detection of VCI in SVD and its differentiation from AD impairment. Further multicentre studies are required to evaluate and compare it with other existing screening tests.
  • 17.

    【2hr】Predicting late-life disability and death by the rate of decline in physical performance measures

    包量

    机译 通过身体机能指标的下降率预测晚年残疾和死亡
    摘要：>Background: the rate of performance decline may influence the risk of disability or death.>Methods: for 4,182 Cardiovascular Health Study participants, we used multinomial Poisson log-linear models to assess the contribution of physical performance in 1998–99, and the rate of performance change between 1992–93 and 1998–99, to the risk of death or disability in 2005–06 in three domains: mobility, upper-extremity function (UEF) and activities of daily living (ADL). We evaluated performance in finger-tapping, grip strength, stride length, gait speed and chair stands separately and together for each outcome, adjusting for age, gender, race and years of disability in that outcome between 1992–93 and 1998–99.>Results: participants’ age averaged 79.4 in 1998–99; 1,901 died over 7 years. Compared with the lowest change quintile in stride length, the highest quintile had a 1.32 relative risk (RR) of ADL disability (95% CI: 1.16 –1.96) and a 1.27 RR of death (95% CI: 1.07 –1.51). The highest change quintile for grip strength increased the risk of ADL disability by 35% (95% CI: 1.13 –1.61) and death by 31% (95% CI: 1.16 –1.49), compared with the lowest quintile. The annual change in stride length and grip strength also predicted disability in mobility and UEF.>Conclusion: performance trajectories independently predict death and disability.
  • 18.

    【2hr】Haemoglobin A1c and cognitive function in very old cognitively intact men

    包量

    机译 血红蛋白A1c和认知功能正常的老年男性的认知功能
    摘要：
  • 19.

    【2hr】The prevalence of mental health problems among older adults admitted as an emergency to a general hospital

    包量

    机译 在综合医院接受急诊的老年人中心理健康问题的普遍性
    摘要：>Background: a high prevalence of co-morbid mental health problems is reported among older adults admitted to general hospitals.>Setting: an 1,800 bed teaching hospital.>Design: consecutive general medical and trauma orthopaedic admissions aged 70 or older were screened for mental health problems. Those screening positive were invited to undergo further assessment, and were interviewed to complete a battery of health status measurements.>Results: of 1,004 patients screened, 36% had no mental health problems or had anxiety alone. Of those screening positive 250 took part in the full study. Adjusting for the two-stage sampling design, 50% of admitted patients over 70 were cognitively impaired, 27% had delirium and 8–32% were depressed. Six percent had hallucinations, 8% delusions, 21% apathy and 9% agitation/aggression (of at least moderate severity). Of those with mental health problems, 47% were incontinent, 49% needed help with feeding and 44% needed major help to transfer.>Interpretation: we confirm the high prevalence of mental health problems among older adults admitted to general hospitals. These patients have high levels of functional dependency, psychological and behavioural problems which have implications for how they are cared for. Services that identify these problems and offer therapeutic intervention should be evaluated.
  • 20.

    【2hr】Socioeconomic status and the trajectory of self-rated health

    包量

    机译 社会经济地位和自我评价的健康轨迹
    摘要：>Background: self-rated health (SRH) likely reflects both mental and physical health domains, and is assessed by asking individuals to describe their health status. Poor SRH is associated with disease incidence and subsequent mortality. Changes in SRH across time in persons with different incident diseases are uncharacterised.>Methods: SRH was assessed in the Atherosclerosis Risk in Communities study via annual telephone interviews over a median of 17.6 years. Individual quadratic growth models were used for repeated measures of SRH in persons who remained disease-free during follow-up (n = 11,188), as well as among those who were diagnosed with myocardial infarction (MI; n = 1,071), stroke (n = 809), heart failure (HF; n = 1,592) or lung cancer (n = 433) and those who underwent a cardiac revascularisation procedure (n = 1,340) during follow-up.>Results: among disease-free participants and across time, there was a trend for lowest mean SRH among persons living in low socioeconomic areas and highest mean SRH among persons living in high socioeconomic areas. Factors contributing to the decline in SRH over time included advanced age, lower educational attainment, smoking and obesity.>Conclusion: addressing factors related to poor SRH trajectories among patients pre- and post-incident disease may favourably affect health outcomes among patients regardless of type of disease.
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