{"title":"内在能力转换可预测总死亡率、特定病因死亡率、事故致残率和医疗保健利用率","authors":"","doi":"10.1016/j.jnha.2024.100359","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>To develop an intrinsic capacity (IC) score and to investigate the association between IC transition with overall and cause-specific mortality, incident disability and healthcare utilization.</p></div><div><h3>Design</h3><p>Retrospective cohort study</p></div><div><h3>Setting and participants</h3><p>Data from 1852 respondents aged ≥ 65 years who completed the 1999 and 2003 surveys of the Taiwan Longitudinal Study on Aging were analyzed.</p></div><div><h3>Measurements</h3><p>Transitions of IC score were categorized into three groups: (1) Improved IC (IC<sub>2003−1999</sub> >0), (2) Stable IC (IC<sub>2003−1999</sub> = 0), (3) Worsened IC (IC<sub>2003−1999</sub> <0). Cox regression and subdistribution hazard models were used to investigate IC transitions and 4-year overall and cause-specific mortality, respectively. Logistic regression were employed to develop weighted IC score (wIC, 0–16) and assess its association with incident disability and healthcare utilization. Similar analysis were repeated using non-weighted IC (nIC, 0–8) to ensure robustness.</p></div><div><h3>Results</h3><p>Comparing to decreased wIC group, stable or increased wIC participants had significantly lower 4-year all-cause mortality, and death from infection, cardiometabolic/cerebrovascular diseases, organ failure and other causes. (Hazard ratio (HR) ranged from 0.36 to 0.56, 95% CI ranged from 0.15 to 1.00, p ≤ 0.049 in the stable wIC group; HR ranged from 0.41 to 0.51, 95% CI ranged from 0.22 to 0.94, p ≤ 0.034 in the increased wIC group). Moreover, individuals with stable or increased wIC demonstrated lower risk of incident disability and hospitalization. (Odds ratio (OR) = ranged from 0.34 to 0.70, 95% CI ranged from 0.19 to 1.00, p ≤ 0.048). Participants with stable wIC also exhibited reduced risk of emergency department visits (OR = 0.58, 95% CI = 0.41 to 0.82, p = 0.002). These results were generally consistent in the nIC model.</p></div><div><h3>Conclusion</h3><p>Participants with stable or increased IC experienced significantly lower all-cause and most cause-specific mortality, incident disability, and healthcare utilization, which was independent of baseline IC and comorbidities. The findings remained consistent across weighted and non-weighted IC model.</p></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1279770724004469/pdfft?md5=3fdf66a01905c42853f4e64d2f19eb96&pid=1-s2.0-S1279770724004469-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Intrinsic capacity transitions predict overall and cause-specific mortality, incident disability, and healthcare utilization\",\"authors\":\"\",\"doi\":\"10.1016/j.jnha.2024.100359\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>To develop an intrinsic capacity (IC) score and to investigate the association between IC transition with overall and cause-specific mortality, incident disability and healthcare utilization.</p></div><div><h3>Design</h3><p>Retrospective cohort study</p></div><div><h3>Setting and participants</h3><p>Data from 1852 respondents aged ≥ 65 years who completed the 1999 and 2003 surveys of the Taiwan Longitudinal Study on Aging were analyzed.</p></div><div><h3>Measurements</h3><p>Transitions of IC score were categorized into three groups: (1) Improved IC (IC<sub>2003−1999</sub> >0), (2) Stable IC (IC<sub>2003−1999</sub> = 0), (3) Worsened IC (IC<sub>2003−1999</sub> <0). Cox regression and subdistribution hazard models were used to investigate IC transitions and 4-year overall and cause-specific mortality, respectively. Logistic regression were employed to develop weighted IC score (wIC, 0–16) and assess its association with incident disability and healthcare utilization. Similar analysis were repeated using non-weighted IC (nIC, 0–8) to ensure robustness.</p></div><div><h3>Results</h3><p>Comparing to decreased wIC group, stable or increased wIC participants had significantly lower 4-year all-cause mortality, and death from infection, cardiometabolic/cerebrovascular diseases, organ failure and other causes. (Hazard ratio (HR) ranged from 0.36 to 0.56, 95% CI ranged from 0.15 to 1.00, p ≤ 0.049 in the stable wIC group; HR ranged from 0.41 to 0.51, 95% CI ranged from 0.22 to 0.94, p ≤ 0.034 in the increased wIC group). Moreover, individuals with stable or increased wIC demonstrated lower risk of incident disability and hospitalization. (Odds ratio (OR) = ranged from 0.34 to 0.70, 95% CI ranged from 0.19 to 1.00, p ≤ 0.048). Participants with stable wIC also exhibited reduced risk of emergency department visits (OR = 0.58, 95% CI = 0.41 to 0.82, p = 0.002). These results were generally consistent in the nIC model.</p></div><div><h3>Conclusion</h3><p>Participants with stable or increased IC experienced significantly lower all-cause and most cause-specific mortality, incident disability, and healthcare utilization, which was independent of baseline IC and comorbidities. 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引用次数: 0
摘要
目的制定一种内在能力(IC)评分,并研究IC转换与总死亡率、特定病因死亡率、意外致残率和医疗保健使用率之间的关系。测量将 IC 评分的变化分为三组:(1) IC 改善(IC2003-1999 >0),(2) IC 稳定(IC2003-1999 = 0),(3) IC 恶化(IC2003-1999 <0)。Cox回归模型和亚分布危险模型分别用于研究IC转变和4年总死亡率及特定病因死亡率。采用逻辑回归法得出加权 IC 评分(wIC,0-16),并评估其与残疾事件和医疗使用的关系。结果与 wIC 下降组相比,wIC 稳定或上升组的 4 年全因死亡率、感染、心血管代谢疾病/脑血管疾病、器官衰竭和其他原因导致的死亡率显著降低。(稳定 wIC 组的危险比(HR)为 0.36 至 0.56,95% CI 为 0.15 至 1.00,P≤0.049;增加 wIC 组的危险比(HR)为 0.41 至 0.51,95% CI 为 0.22 至 0.94,P≤0.034)。此外,wIC稳定或增加的人群发生残疾和住院的风险较低。(比值比(OR)= 0.34 至 0.70,95% CI 为 0.19 至 1.00,P ≤ 0.048)。具有稳定 wIC 的参试者到急诊室就诊的风险也有所降低(OR = 0.58,95% CI = 0.41 至 0.82,p = 0.002)。这些结果在 nIC 模型中基本一致。结论IC 稳定或增加的参与者的全因死亡率和大多数特定病因死亡率、残疾发生率和医疗保健使用率显著降低,这与基线 IC 和合并症无关。这些发现在加权和非加权 IC 模型中保持一致。
Intrinsic capacity transitions predict overall and cause-specific mortality, incident disability, and healthcare utilization
Objectives
To develop an intrinsic capacity (IC) score and to investigate the association between IC transition with overall and cause-specific mortality, incident disability and healthcare utilization.
Design
Retrospective cohort study
Setting and participants
Data from 1852 respondents aged ≥ 65 years who completed the 1999 and 2003 surveys of the Taiwan Longitudinal Study on Aging were analyzed.
Measurements
Transitions of IC score were categorized into three groups: (1) Improved IC (IC2003−1999 >0), (2) Stable IC (IC2003−1999 = 0), (3) Worsened IC (IC2003−1999 <0). Cox regression and subdistribution hazard models were used to investigate IC transitions and 4-year overall and cause-specific mortality, respectively. Logistic regression were employed to develop weighted IC score (wIC, 0–16) and assess its association with incident disability and healthcare utilization. Similar analysis were repeated using non-weighted IC (nIC, 0–8) to ensure robustness.
Results
Comparing to decreased wIC group, stable or increased wIC participants had significantly lower 4-year all-cause mortality, and death from infection, cardiometabolic/cerebrovascular diseases, organ failure and other causes. (Hazard ratio (HR) ranged from 0.36 to 0.56, 95% CI ranged from 0.15 to 1.00, p ≤ 0.049 in the stable wIC group; HR ranged from 0.41 to 0.51, 95% CI ranged from 0.22 to 0.94, p ≤ 0.034 in the increased wIC group). Moreover, individuals with stable or increased wIC demonstrated lower risk of incident disability and hospitalization. (Odds ratio (OR) = ranged from 0.34 to 0.70, 95% CI ranged from 0.19 to 1.00, p ≤ 0.048). Participants with stable wIC also exhibited reduced risk of emergency department visits (OR = 0.58, 95% CI = 0.41 to 0.82, p = 0.002). These results were generally consistent in the nIC model.
Conclusion
Participants with stable or increased IC experienced significantly lower all-cause and most cause-specific mortality, incident disability, and healthcare utilization, which was independent of baseline IC and comorbidities. The findings remained consistent across weighted and non-weighted IC model.
期刊介绍:
There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.