高齢者における所得・教育年数別の死亡・要介護認定率とその性差:AGESプロジェクト縦断研究  [in Japanese] The Relationship between Socio-economic Status and the Loss of Healthy Aging, and Relevant Gender Differences in the Japanese Older Population:AGES Project Longitudinal Study  [in Japanese]

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Abstract

日本の高齢者における等価所得・教育年数と死亡,要介護認定,健康寿命の喪失(死亡または要介護認定)との関連を明らかにすることを目的とした。協力を得られた6自治体に居住する高齢者14,652人(平均年齢71.0歳)を4年(1,461日)間追跡し,要介護認定および死亡データを得た。Cox比例ハザードモデルを用い,死亡,要介護認定,健康寿命の喪失をエンドポイントに等価所得・教育年数(共に5区分)を同時投入して年齢調整済みハザード比(HR)を男女別に求めた。<br>その結果,男性では,最高所得層に比べ最低所得層でHR1.55-1.75,最長教育年数に比べ最短教育年数層ではHR1.45-1.97の統計学的にも有意な健康格差を認めた。一方,女性では,所得で0.92-1.22,教育年数で1.00-1.35と有意な健康格差は認めなかった。等価所得と教育年数の2つの社会経済指標と用いた健康指標(死亡,要介護認定,健康寿命の喪失)とで,健康格差の大きさも関連の程度も異なっていた。<br>日本の高齢男性には,統計学的に有意な健康格差を認めたが,女性では認めなかった。これは健康格差が(少)ない社会・集団がありうる可能性を示唆しており,所見の再現性の検証や健康格差のモニタリング,生成機序の解明などが望まれる。

The purpose of this study was to identify inequalities in the loss of healthy aging (mortality or functional decline) in the Japanese older population.<br>We analyzed longitudinal data from the Aichi Gerontological Evaluation Study (AGES) project. Subjects were 14,652 older people (mean age : 71.0 yrs) in 6 municipalities in Japan followed for 4 years (1,461 days). Municipalities provided information about mortality and long-term care insurance benefit certification. Subjects were divided into 5 groups based on equivalent income and educational attainment. The cox proportional hazard model was used to obtain age-adjusted hazard ratios for death, new long-term care insurance benefit certification, and a combination of the two. Groups with the highest income and educational attainment were used as a reference. Men and women were analyzed separately.<br>In men, significant health inequalities were observed between the highest income group and lowest income group (HR1.55-1.75), and between the highest educational attainment group and lowest educational attainment group (HR1.45-1.97). In contrast, no inequalities were seen in women regarding either income (HR 0.92-1.22) or education (HR1.00-1.35).<br>In the Japanese older population studied, men with the highest income and educational attainment showed healthier aging and lower mortality compared to men with the lowest income and educational attainment. No such differences were seen among females for either factor. These findings suggest the existence of groups with little or no health inequalities. Further studies are needed to confirm the reproducibility of these findings, to monitor such inequalities, and to reveal the mechanisms underlying health inequalities.

Journal

  • Iryo To Shakai

    Iryo To Shakai 22(1), 19-30, 2012

    The Health Care Science Institute

Codes

  • NII Article ID (NAID)
    130004851770
  • NII NACSIS-CAT ID (NCID)
    AN10372213
  • Text Lang
    JPN
  • ISSN
    0916-9202
  • NDL Article ID
    023739493
  • NDL Call No.
    Z19-3523
  • Data Source
    NDL  J-STAGE 
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