OBJECTIVE:The objectives of this work were to determine the prevalence of self-reported subclinical status for functional limitation and disability at baseline and assess their independent effects on the onset of functional limitation and disability 1-2 years later. METHODS:Nine hundred ninety-eight African American men and women 49-65 years old in St. Louis, MO, received comprehensive in-home evaluations at baseline and two annual telephone follow-ups. Outcome measures included walking a half-mile, climbing steps, stooping-crouching-kneeling, lifting or carrying 10 lbs., and doing heavy housework. RESULT:The baseline prevalence of subclinical status was 26.4% for walking a half-mile, 26.8% for climbing steps, 39.0% for stooping-crouching-kneeling, 29.1% for lifting or carrying 10 lbs., and 22.7% for doing heavy housework. The adjusted odds ratios for the task-specific subclinical status measure at baseline on developing difficulty 1-2 years later were 1.68 (p < .05) for walking a half-mile, 4.46 (p < .001) for climbing steps, 2.48 (p < .001) for stooping-crouching-kneeling, 2.51 (p < .001) for lifting or carrying 10 lbs., and 2.22 (p < .001) for doing heavy housework. Performance tests (tandem stand, chair stands, and preferred gait speed) did not have consistent independent effects on the onset of functional limitation or disability. CONCLUSION:The subclinical status measures were the main predictors of the onset of difficulty in all tasks and functions 1-2 years later. Interventions to reduce frailty should focus on self-reported subclinical status as an early warning system.

译文

目的:这项工作的目的是确定基线时自我报告的功能受限和残障亚临床状态的普遍性,并评估其在1-2年后对功能受限和残障发作的独立影响。
方法:密苏里州圣路易斯的988名49-65岁的非洲裔美国人,在基线时接受了全面的室内评估,并接受了两次年度电话随访。结果措施包括步行半英里,爬上台阶,弯腰蹲下跪,举起或抬起10磅体重以及做繁重的家务劳动。
结果:亚临床状态的基线患病率是半英里步行26.4%,爬山台阶26.8%,弯腰屈膝跪姿39.0%,举重或举重10磅29.1%,繁重的家务劳动22.7% 。在1-2年后因发展困难而在基线时针对特定任务的亚临床状态测量值的调整后优势比为:半英里步行时为1.68(p <.05),攀登步骤为4.46(p <.001),为2.48(p跪着蹲下时p <.001),举起或搬运10磅重时为2.51(p <.001),而做繁重的家务则为2.22(p <.001)。性能测试(纵排站立,椅子站立和优选的步态速度)对功能受限或残疾的发作没有一致的独立影响。
结论:亚临床状态测量是1-2年后所有任务和功能出现困难的主要预测指标。减少体弱的干预措施应着重于自我报告的亚临床状态,作为预警系统。

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