老年人的步速与生存。
Gait speed and survival in older adults.
机构信息
Department of Medicine, Division of Geratric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
出版信息
JAMA. 2011 Jan 5;305(1):50-8. doi: 10.1001/jama.2010.1923.
CONTEXT
Survival estimates help individualize goals of care for geriatric patients, but life tables fail to account for the great variability in survival. Physical performance measures, such as gait speed, might help account for variability, allowing clinicians to make more individualized estimates.
OBJECTIVE
To evaluate the relationship between gait speed and survival.
DESIGN, SETTING, AND PARTICIPANTS: Pooled analysis of 9 cohort studies (collected between 1986 and 2000), using individual data from 34,485 community-dwelling older adults aged 65 years or older with baseline gait speed data, followed up for 6 to 21 years. Participants were a mean (SD) age of 73.5 (5.9) years; 59.6%, women; and 79.8%, white; and had a mean (SD) gait speed of 0.92 (0.27) m/s.
MAIN OUTCOME MEASURES
Survival rates and life expectancy.
RESULTS
There were 17,528 deaths; the overall 5-year survival rate was 84.8% (confidence interval [CI], 79.6%-88.8%) and 10-year survival rate was 59.7% (95% CI, 46.5%-70.6%). Gait speed was associated with survival in all studies (pooled hazard ratio per 0.1 m/s, 0.88; 95% CI, 0.87-0.90; P < .001). Survival increased across the full range of gait speeds, with significant increments per 0.1 m/s. At age 75, predicted 10-year survival across the range of gait speeds ranged from 19% to 87% in men and from 35% to 91% in women. Predicted survival based on age, sex, and gait speed was as accurate as predicted based on age, sex, use of mobility aids, and self-reported function or as age, sex, chronic conditions, smoking history, blood pressure, body mass index, and hospitalization.
CONCLUSION
In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.
背景
生存估计有助于为老年患者确定个体化的治疗目标，但生命表并不能完全反映生存的巨大变异性。身体机能测量，如步速，可能有助于解释变异性，使临床医生能够做出更个体化的估计。
目的
评估步速与生存之间的关系。
设计、地点和参与者：对 9 项队列研究（收集于 1986 年至 2000 年之间）进行的汇总分析，使用了来自 34485 名年龄在 65 岁或以上、基线步速数据、随访 6 至 21 年的居住在社区的老年人的个体数据。参与者的平均（标准差）年龄为 73.5（5.9）岁；59.6%为女性；79.8%为白人；平均（标准差）步速为 0.92（0.27）m/s。
主要观察指标
生存率和预期寿命。
结果
共有 17528 人死亡；总体 5 年生存率为 84.8%（置信区间[CI]，79.6%-88.8%），10 年生存率为 59.7%（95%CI，46.5%-70.6%）。在所有研究中，步速均与生存率相关（每 0.1m/s 的合并危险比为 0.88；95%CI，0.87-0.90；P<.001）。随着步速的增加，生存率呈递增趋势，每增加 0.1m/s 生存率就会显著提高。在 75 岁时，男性在步速范围内预测的 10 年生存率从 19%到 87%不等，女性从 35%到 91%不等。基于年龄、性别、步速的预测生存率与基于年龄、性别、使用助行器、自我报告的功能或年龄、性别、慢性疾病、吸烟史、血压、体重指数和住院情况的预测生存率一样准确。
结论
在这项对 9 个选定队列的个体数据的汇总分析中，步速与老年人的生存有关。
Zotero 插件