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要旨
目的:高齢者用社会的診断手法の開発のため,余命と生活の質(QOL)の影響要因を探索した.
方法:2007年に長野県Y村全住民の心身機能・生活状況・QOL・低栄養リスクの実態を調査した.2014年に前調査時65歳以上であった高齢者に追跡調査を実施し,余命とQOLに影響する要因を追究した.
結果:余命に最も影響する要因は,心身機能的側面では男女とも年齢で,社会・経済的側面では,男性は「外出方法(自動車の運転の有無)」,女性は「普段の過ごし方(寝たり起きたりかどうか)」であった.身体的QOLに最も影響する要因は,男性は日常生活活動(ADL)の変化,女性は年齢であった.精神的QOLに最も影響する要因は,男性は外出頻度,女性はADLの変化であった.
結論:余命に影響する要因はQOLのそれと一致せず,長寿とQOLの維持・向上とは必ずしもつながらないことが示唆された.また,影響する要因には性差があった.QOLの維持・向上には,ADLを維持し,個人のライフスタイルを継続する支援が重要である.
Objective:We investigated factors that influence variations in life expectancy and quality of life (QOL), to develop social diagnostic scales for the elderly.
Methods:In 2007, we investigated mental and physical functioning, living conditions, QOL, and malnutrition risks among the population of village Y in Nagano Prefecture. In 2014, we conducted a follow-up investigation among those who were aged 65 years or older at the time of the previous investigation. Factors influencing mortality and variations in QOL were analyzed.
Results:For mental/physical functioning, the factor with the largest influence on life expectancy was age ≥ 80.5 years in both men and women. The socioeconomic factors that had the largest influence on life expectancy were driving an automobile for men and way of spending the day (lying in and moving around the bed) for women. Physical aspects of QOL were most strongly affect by changes in ADL for men and age ≥ 79.5 years for women. The factors with the largest influence on mental aspects of QOL were frequency of going outside one's home/building for men and changes in ADL for women.
Conclusions:(1) The factors influencing life expectancy and QOL differed, and longevity was not necessarily linked to QOL. (2) Sex differences were found to exist among the various factors. (3) Providing support and assurance for individual life styles (based on ADL independence) in this population is important for maintenance and improvement of QOL.
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