休闲活动与老年人内在能力下降的前瞻性队列研究  

A prospective cohort study of leisure activities and declining intrinsic capacity in older adults

作　　者：张洁[1] 沈姞[1] 亢玉婷 张驰[3] 庞婧[3] 李宏宇 施红[1] Zhang Jie;Shen Ji;Kang Yuting;Zhang Chi;Pang Jing;Li Hongyu;Shi Hong(Department of Geriatric Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Office of the National Clinical Research Center for Geriatric Diseases,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;The Key Laboratory of Geriatrics,Beijing Institute of Geriatrics,Beijing Hospital,National Center of Gerontology,National Health Commission)

机构地区：[1]北京医院老年医学科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]北京医院国家老年疾病临床医学研究中心办公室,中国医学科学院老年医学研究院,北京100730 [3]北京医院,国家老年医学中心,国家卫生健康委北京老年医学研究所,国家卫生健康委老年医学重点实验室,中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2024年第6期739-744,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划"政府间国际科技创新合作"重点专项(2021YFE0111800);北京医院科技新星项目(BJ-2020-090);中央高水平医院临床科研业务费(BJ-2022-149)。

摘　　要：目的:调查老年人内在能力变化轨迹,探讨休闲活动对老年人内在能力下降的影响。方法:前瞻性队列研究,于2020年11—12月采用便利抽样方法,选择北京市某社区284例老年人进行调查,采集老年人一般情况、内在能力(包括认知、活力、运动、心理及感知觉5个维度)及休闲活动参与情况,并对调查对象进行2.5年随访。结果:最终243例(85.6%、243/284)老年人完成了2.5年随访;随访内在能力得分为3(3,4)分,较基线水平4(3,4)分降低(Z=-4.667,P<0.001),113例(46.5%、113/243)老年人出现内在能力下降,运动及心理维度下降较为明显(χ2=16.953、23.510,均P<0.001);休闲活动低分组较高分组内在能力下降人数更多[62.2%(56/90)比37.3%(57/153),χ2=14.199,P<0.001],休闲活动得分与随访内在能力得分呈正相关(r=0.200、P=0.002),与内在能力的得分变化值呈正相关(r=0.146、P=0.023);多因素Logistic回归分析结果显示,矫正人口学因素、疾病数目及服药种类后,休闲活动得分(OR=0.644、95%CI:0.507~0.818、P<0.001)、体力类休闲活动(OR=0.565、95%CI:0.395~0.809、P=0.002)及智力类休闲活动(OR=0.742、95%CI:0.555~0.992、P=0.044)均对老年人内在能力下降具有独立的影响作用。结论:老年人内在能力下降较为普遍,参与休闲活动有利于减少内在能力下降,应注重休闲活动对老年人健康的影响。Objective To investigate the trajectories of intrinsic capacity in older adults and explore the impact of leisure activities on the decline of intrinsic capacity.Methods This study is a prospective cohort study conducted in a community in Beijing,China.A convenience sampling method was used to select 284 cases of older adults from November to December 2020.The purpose of the study was to gather information on the general conditions,intrinsic abilities(including cognitive,vitality,motor,psychological,and sensory dimensions),and participation in leisure activities of older adults.A 2.5-year follow-up of the respondents was conducted.Results A total of 243(85.6%,243/284)respondents completed the 2.5-year follow-up.The follow-up intrinsic capacity score decreased from a baseline level of 4(3,4)to 3(3,4)(Z=-4.667,P<0.001).Among the respondents,113(46.5%,113/243)older adults showed a decrease in intrinsic capacity,with more significant decreases observed in the locomotor and psychometric dimensions(χ2=16.953,23.510,both P<0.001).The number of declines in intrinsic ability was higher in the low group of leisure activities compared to the high group[62.2%(56/90)vs.37.3%(57/153),χ2=14.199,P<0.001].There was a positive correlation between leisure activity scores and the follow-up intrinsic capacity score(r=0.200,P=0.002),as well as with the value of change in the score of intrinsic capacity(r=0.146,P=0.023).The results of Logistic regression analysis indicated that leisure activities(OR=0.644,95%CI:0.507 to 0.818,P<0.001),physical leisure activities(OR=0.565,95%CI:0.395 to 0.809,P=0.002),and intellectual leisure activities(OR=0.742,95%CI:0.555 to 0.992,P=0.044)independently influenced the decline of intrinsic ability in the elderly,even after accounting for demographic information,number of diseases,and type of medicine taken.Conclusions The decline in intrinsic abilities is a common occurrence among the elderly population.Engaging in leisure activities has been found to be effective in reducing this decline.It is import

关 键 词：认知 社会适应 内在能力 休闲活动 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]