高齢者のヘルスリテラシーが2年後のフレイルの有無に及ぼす影響―前向きコホート研究
目的：本研究の目的は，高齢者のヘルスリテラシーが2年後のフレイルの有無に及ぼす影響を検討することとした．方法：解析対象は，65歳以上のフレイルでない地域在住高齢者218名〔平均年齢72.5±4.9歳（範囲：65から86歳），男性81名〕とした．機能的ヘルスリテラシーをNewest Vital Signにより，包括的ヘルスリテラシーをEuropean Health Literacy Survey Questionnaireにより評価した．包括的ヘルスリテラシーは総得点に加えて，ヘルスケア，疾病予防，ヘルスプロモーションの3領域の得点についても算出した．2年後のフォローアップ評価（郵送調査）におけ...
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| Published in | 日本老年医学会雑誌 Vol. 58; no. 1; pp. 101 - 110 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本老年医学会
25.01.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0300-9173 |
| DOI | 10.3143/geriatrics.58.101 |
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| Abstract | 目的：本研究の目的は，高齢者のヘルスリテラシーが2年後のフレイルの有無に及ぼす影響を検討することとした．方法：解析対象は，65歳以上のフレイルでない地域在住高齢者218名〔平均年齢72.5±4.9歳（範囲：65から86歳），男性81名〕とした．機能的ヘルスリテラシーをNewest Vital Signにより，包括的ヘルスリテラシーをEuropean Health Literacy Survey Questionnaireにより評価した．包括的ヘルスリテラシーは総得点に加えて，ヘルスケア，疾病予防，ヘルスプロモーションの3領域の得点についても算出した．2年後のフォローアップ評価（郵送調査）における基本チェックリストの合計点が8点以上の場合をフレイル有とした．結果：フォローアップ評価の対象者253名のうち，226名から回答が得られた（追跡率：89.3%）．欠損値ありの8名を除いた218名のうち，2年後にフレイル有となったのは25名（11.5%）であった．年齢，性別，教育年数，BMI，歩行速度，認知機能，Comorbidityで調整したロジスティック回帰モデルにおいて，包括的ヘルスリテラシーの得点のみがフレイルと有意な関連を示した〔1SDあたりのオッズ比（95%信頼区間）＝0.54（0.33～0.87）〕．包括的ヘルスリテラシーのヘルスケア，疾病予防領域の得点についても同様に有意な関連を示し，いずれも得点が高いほど，フレイルのオッズ比が低いことを示した．結論：包括的ヘルスリテラシーが高い高齢者では，2年後にフレイルを有する危険性が低いことが明らかになった． |
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| AbstractList | 目的：本研究の目的は，高齢者のヘルスリテラシーが2年後のフレイルの有無に及ぼす影響を検討することとした．方法：解析対象は，65歳以上のフレイルでない地域在住高齢者218名〔平均年齢72.5±4.9歳（範囲：65から86歳），男性81名〕とした．機能的ヘルスリテラシーをNewest Vital Signにより，包括的ヘルスリテラシーをEuropean Health Literacy Survey Questionnaireにより評価した．包括的ヘルスリテラシーは総得点に加えて，ヘルスケア，疾病予防，ヘルスプロモーションの3領域の得点についても算出した．2年後のフォローアップ評価（郵送調査）における基本チェックリストの合計点が8点以上の場合をフレイル有とした．結果：フォローアップ評価の対象者253名のうち，226名から回答が得られた（追跡率：89.3%）．欠損値ありの8名を除いた218名のうち，2年後にフレイル有となったのは25名（11.5%）であった．年齢，性別，教育年数，BMI，歩行速度，認知機能，Comorbidityで調整したロジスティック回帰モデルにおいて，包括的ヘルスリテラシーの得点のみがフレイルと有意な関連を示した〔1SDあたりのオッズ比（95%信頼区間）＝0.54（0.33～0.87）〕．包括的ヘルスリテラシーのヘルスケア，疾病予防領域の得点についても同様に有意な関連を示し，いずれも得点が高いほど，フレイルのオッズ比が低いことを示した．結論：包括的ヘルスリテラシーが高い高齢者では，2年後にフレイルを有する危険性が低いことが明らかになった． |
| Author | 岡本, 啓 山田, 実 渡邉, 敦也 上村, 一貴 紙谷, 司 |
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| Copyright | 2021 一般社団法人 日本老年医学会 |
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| References | 21) Nakayama K, Osaka W, Togari T, Ishikawa H, Yonekura Y, Sekido A, et al.: Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy. BMC Public Health 2015; 15: 505. 35) Ofori-Asenso R, Chin KL, Mazidi M, Zomer E, Ilomaki J, Zullo AR, et al.: Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA Network Open 2019; 2 (8): e198398-e198398. 3) Sandoval-Insausti H, Perez-Tasigchana RF, Lopez-Garcia E, Garcia-Esquinas E, Rodriguez-Artalejo F, Guallar-Castillon P: Macronutrients Intake and Incident Frailty in Older Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2016; 71 (10): 1329-1334. 13) Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al.: Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012; 12: 80. 7) 石川ひろの: ヘルスリテラシーの評価法. ヘルスリテラシー-健康教育の新しいキーワード (福田 洋, 江口泰正編), 大修館書店, 東京, 2016, p44. 18) Huang CH, Lai YC, Lee YC, Teong XT, Kuzuya M, Kuo KM: Impact of Health Literacy on Frailty among Community-Dwelling Seniors. J Clin Med 2018; 7 (12): 481. 12) Nutbeam D: Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 2000; 15 (3): 259-267. 17) Shirooka H, Nishiguchi S, Fukutani N, Adachi D, Tashiro Y, Hotta T, et al.: Association between comprehensive health literacy and frailty level in community-dwelling older adults: A cross-sectional study in Japan. Geriatr Gerontol Int 2017; 17 (5): 804-809. 29) Dedeyne L, Deschodt M, Verschueren S, Tournoy J, Gielen E: Effects of multi-domain interventions in (pre) frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv Aging 2017; 12: 873-896. 33) Uemura K, Yamada M, Okamoto H: Effects of active learning on health literacy and behavior in older adults: a randomized controlled trial. Journal of the American Geriatrics Society 2018; 66 (9): 1721-1729. 16) Eronen J, Paakkari L, Portegijs E, Saajanaho M, Rantanen T: Assessment of health literacy among older Finns. Aging Clin Exp Res 2019; 31 (4): 549-556. 14) Suka M, Odajima T, Okamoto M, Sumitani M, Igarashi A, Ishikawa H, et al.: Relationship between health literacy, health information access, health behavior, and health status in Japanese people. Patient Educ Couns 2015; 98 (5): 660-668. 6) United Nations Economic and Social Council (ECOSOC): Health literacy and the Millennium Development Goals: United Nations Economic and Social Council (ECOSOC) regional meeting background paper. J Health Commun 2010; 15: 211-223. 24) Shah A, Ferri-Guerra J, Nadeem MY, Salguero D, Aparicio-Ugarriza R, Desir M, et al.: The association of health literacy, numeracy and graph literacy with frailty. Aging Clin Exp Res 2019; 31 (12): 1827-1832. 1) 厚生労働省: 2040年を展望した社会保障・働き方改革本部のとりまとめについて (令和元年6月). https://www.mhlw.go.jp/content/12401000/000517328.pdf (accessed 2020-6-12). 34) 上村一貴, 山田, 実, 岡本, 啓: 高齢者の介護予防を目的としたアクティブ・ラーニング型健康教育の地域実践 -住民主体による取り組み-. 理学療法学 2019; 46 (6): 275-282. 27) Trevisan C, Veronese N, Maggi S, Baggio G, Toffanello ED, Zambon S, et al.: Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc 2017; 65 (1): 179-184. 4) Feng Z, Lugtenberg M, Franse C, Fang X, Hu S, Jin C, et al.: Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One 2017; 12 (6): e0178383. 30) Trombetti A, Hars M, Hsu FC, Reid KF, Church TS, Gill TM, et al.: Effect of physical activity on frailty: secondary analysis of a randomized controlled trial. Ann Intern Med 2018; 168 (5): 309-316. 9) Marciano L, Camerini AL, Schulz PJ: The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis. J Gen Intern Med 2019; 34 (6): 1007-1017. 20) Kogure T, Sumitani M, Suka M, Ishikawa H, Odajima T, Igarashi A, et al.: Validity and reliability of the Japanese version of the Newest Vital Sign: a preliminary study. PLoS One 2014; 9 (4): e94582. 26) Pollack LR, Litwack-Harrison S, Cawthon PM, Ensrud K, Lane NE, Barrett-Connor E, et al.: Patterns and Predictors of Frailty Transitions in Older Men: The Osteoporotic Fractures in Men Study. J Am Geriatr Soc 2017; 65: 2473-2479. 5) Wang X, Lu Y, Li C, Larbi A, Feng L, Shen Q, et al.: Associations of lifestyle activities and a heathy diet with frailty in old age: a community-based study in Singapore. Aging (Albany NY) 2020; 12 (1): 288-308. 11) Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K: Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 2011; 155 (2): 97-107. 31) Kojima G, Iliffe S, Taniguchi Y, Shimada H, Rakugi H, Walters K: Prevalence of frailty in Japan: A systematic review and meta-analysis. J Epidemiol 2017; 27 (8): 347-353. 23) Satake S, Senda K, Hong YJ, Miura H, Endo H, Sakurai T, et al.: Validity of the Kihon Checklist for assessing frailty status. Geriatr Gerontol Int 2016; 16 (6): 709-715. 32) Walters R, Leslie SJ, Polson R, Cusack T, Gorely T: Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review. BMC public health 2020; 20 (1): 1040. 19) Satake S, Shimada H, Yamada M, Kim H, Yoshida H, Gondo Y, et al.: Prevalence of frailty among community-dwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatr Gerontol Int 2017; 17 (12): 2629-2634. 22) 牧迫飛雄馬, 古名丈人, 島田裕之, 赤沼智美, 吉田裕人, 井平 光ほか: 後期高齢者における新規要介護認定の発生と5m歩行時間との関連: 39ヵ月間の縦断研究. 理学療法学 2011; 38 (1): 27-33. 10) Roh YH, Koh YD, Noh JH, Gong HS, Baek GH: Effect of health literacy on adherence to osteoporosis treatment among patients with distal radius fracture. Arch Osteoporos 2017; 12 (1): 42. 8) Parker RM, Baker DW, Williams MV, Nurss JR: The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills. J Gen Intern Med 1995; 10 (10): 537-541. 15) Vandenbosch J, Van den Broucke S, Vancorenland S, Avalosse H, Verniest R, Callens M: Health literacy and the use of healthcare services in Belgium. J Epidemiol Community Health 2016; 70 (10): 1032-1038. 28) Aaby A, Friis K, Christensen B, Rowlands G, Maindal HT: Health literacy is associated with health behaviour and self-reported health: A large population-based study in individuals with cardiovascular disease. Eur J Prev Cardiol 2017; 24 (17): 1880-1888. 2) Yuki A, Otsuka R, Tange C, Nishita Y, Tomida M, Ando F, et al.: Daily Physical Activity Predicts Frailty Development Among Community-Dwelling Older Japanese Adults. J Am Med Dir Assoc 2019; 20 (8): 1032-1036. 25) 吉田裕人, 西真理子, 渡辺直紀, 藤原佳典, 深谷太郎, 小川貴志子ほか: FI-J (Frailty Index for Japanese elderly) を用いた「虚弱」の予知因子に関する研究. 日本老年医学会雑誌 2012; 49 (4): 442-448. |
| References_xml | – reference: 14) Suka M, Odajima T, Okamoto M, Sumitani M, Igarashi A, Ishikawa H, et al.: Relationship between health literacy, health information access, health behavior, and health status in Japanese people. Patient Educ Couns 2015; 98 (5): 660-668. – reference: 29) Dedeyne L, Deschodt M, Verschueren S, Tournoy J, Gielen E: Effects of multi-domain interventions in (pre) frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv Aging 2017; 12: 873-896. – reference: 32) Walters R, Leslie SJ, Polson R, Cusack T, Gorely T: Establishing the efficacy of interventions to improve health literacy and health behaviours: a systematic review. BMC public health 2020; 20 (1): 1040. – reference: 26) Pollack LR, Litwack-Harrison S, Cawthon PM, Ensrud K, Lane NE, Barrett-Connor E, et al.: Patterns and Predictors of Frailty Transitions in Older Men: The Osteoporotic Fractures in Men Study. J Am Geriatr Soc 2017; 65: 2473-2479. – reference: 9) Marciano L, Camerini AL, Schulz PJ: The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis. J Gen Intern Med 2019; 34 (6): 1007-1017. – reference: 15) Vandenbosch J, Van den Broucke S, Vancorenland S, Avalosse H, Verniest R, Callens M: Health literacy and the use of healthcare services in Belgium. J Epidemiol Community Health 2016; 70 (10): 1032-1038. – reference: 19) Satake S, Shimada H, Yamada M, Kim H, Yoshida H, Gondo Y, et al.: Prevalence of frailty among community-dwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatr Gerontol Int 2017; 17 (12): 2629-2634. – reference: 11) Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K: Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 2011; 155 (2): 97-107. – reference: 12) Nutbeam D: Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 2000; 15 (3): 259-267. – reference: 4) Feng Z, Lugtenberg M, Franse C, Fang X, Hu S, Jin C, et al.: Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLoS One 2017; 12 (6): e0178383. – reference: 3) Sandoval-Insausti H, Perez-Tasigchana RF, Lopez-Garcia E, Garcia-Esquinas E, Rodriguez-Artalejo F, Guallar-Castillon P: Macronutrients Intake and Incident Frailty in Older Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2016; 71 (10): 1329-1334. – reference: 22) 牧迫飛雄馬, 古名丈人, 島田裕之, 赤沼智美, 吉田裕人, 井平 光ほか: 後期高齢者における新規要介護認定の発生と5m歩行時間との関連: 39ヵ月間の縦断研究. 理学療法学 2011; 38 (1): 27-33. – reference: 25) 吉田裕人, 西真理子, 渡辺直紀, 藤原佳典, 深谷太郎, 小川貴志子ほか: FI-J (Frailty Index for Japanese elderly) を用いた「虚弱」の予知因子に関する研究. 日本老年医学会雑誌 2012; 49 (4): 442-448. – reference: 18) Huang CH, Lai YC, Lee YC, Teong XT, Kuzuya M, Kuo KM: Impact of Health Literacy on Frailty among Community-Dwelling Seniors. J Clin Med 2018; 7 (12): 481. – reference: 7) 石川ひろの: ヘルスリテラシーの評価法. ヘルスリテラシー-健康教育の新しいキーワード (福田 洋, 江口泰正編), 大修館書店, 東京, 2016, p44. – reference: 20) Kogure T, Sumitani M, Suka M, Ishikawa H, Odajima T, Igarashi A, et al.: Validity and reliability of the Japanese version of the Newest Vital Sign: a preliminary study. PLoS One 2014; 9 (4): e94582. – reference: 16) Eronen J, Paakkari L, Portegijs E, Saajanaho M, Rantanen T: Assessment of health literacy among older Finns. Aging Clin Exp Res 2019; 31 (4): 549-556. – reference: 10) Roh YH, Koh YD, Noh JH, Gong HS, Baek GH: Effect of health literacy on adherence to osteoporosis treatment among patients with distal radius fracture. Arch Osteoporos 2017; 12 (1): 42. – reference: 5) Wang X, Lu Y, Li C, Larbi A, Feng L, Shen Q, et al.: Associations of lifestyle activities and a heathy diet with frailty in old age: a community-based study in Singapore. Aging (Albany NY) 2020; 12 (1): 288-308. – reference: 21) Nakayama K, Osaka W, Togari T, Ishikawa H, Yonekura Y, Sekido A, et al.: Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy. BMC Public Health 2015; 15: 505. – reference: 35) Ofori-Asenso R, Chin KL, Mazidi M, Zomer E, Ilomaki J, Zullo AR, et al.: Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA Network Open 2019; 2 (8): e198398-e198398. – reference: 17) Shirooka H, Nishiguchi S, Fukutani N, Adachi D, Tashiro Y, Hotta T, et al.: Association between comprehensive health literacy and frailty level in community-dwelling older adults: A cross-sectional study in Japan. Geriatr Gerontol Int 2017; 17 (5): 804-809. – reference: 30) Trombetti A, Hars M, Hsu FC, Reid KF, Church TS, Gill TM, et al.: Effect of physical activity on frailty: secondary analysis of a randomized controlled trial. Ann Intern Med 2018; 168 (5): 309-316. – reference: 6) United Nations Economic and Social Council (ECOSOC): Health literacy and the Millennium Development Goals: United Nations Economic and Social Council (ECOSOC) regional meeting background paper. J Health Commun 2010; 15: 211-223. – reference: 8) Parker RM, Baker DW, Williams MV, Nurss JR: The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills. J Gen Intern Med 1995; 10 (10): 537-541. – reference: 2) Yuki A, Otsuka R, Tange C, Nishita Y, Tomida M, Ando F, et al.: Daily Physical Activity Predicts Frailty Development Among Community-Dwelling Older Japanese Adults. J Am Med Dir Assoc 2019; 20 (8): 1032-1036. – reference: 24) Shah A, Ferri-Guerra J, Nadeem MY, Salguero D, Aparicio-Ugarriza R, Desir M, et al.: The association of health literacy, numeracy and graph literacy with frailty. Aging Clin Exp Res 2019; 31 (12): 1827-1832. – reference: 13) Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al.: Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 2012; 12: 80. – reference: 23) Satake S, Senda K, Hong YJ, Miura H, Endo H, Sakurai T, et al.: Validity of the Kihon Checklist for assessing frailty status. Geriatr Gerontol Int 2016; 16 (6): 709-715. – reference: 1) 厚生労働省: 2040年を展望した社会保障・働き方改革本部のとりまとめについて (令和元年6月). https://www.mhlw.go.jp/content/12401000/000517328.pdf (accessed 2020-6-12). – reference: 33) Uemura K, Yamada M, Okamoto H: Effects of active learning on health literacy and behavior in older adults: a randomized controlled trial. Journal of the American Geriatrics Society 2018; 66 (9): 1721-1729. – reference: 27) Trevisan C, Veronese N, Maggi S, Baggio G, Toffanello ED, Zambon S, et al.: Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc 2017; 65 (1): 179-184. – reference: 28) Aaby A, Friis K, Christensen B, Rowlands G, Maindal HT: Health literacy is associated with health behaviour and self-reported health: A large population-based study in individuals with cardiovascular disease. 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| Snippet | 目的：本研究の目的は，高齢者のヘルスリテラシーが2年後のフレイルの有無に及ぼす影響を検討することとした．方法：解析対象は，65歳以上のフレイルでない地域在住高齢者218名〔平均年齢72.5±4.9歳（範囲：65から86歳），男性81名〕とした．機能的ヘルスリテラシーをNewest Vital... |
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| StartPage | 101 |
| SubjectTerms | フレイル 包括的ヘルスリテラシー 地域在住高齢者 機能的ヘルスリテラシー 追跡調査 |
| Title | 高齢者のヘルスリテラシーが2年後のフレイルの有無に及ぼす影響―前向きコホート研究 |
| URI | https://www.jstage.jst.go.jp/article/geriatrics/58/1/58_58.101/_article/-char/ja |
| Volume | 58 |
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| ispartofPNX | 日本老年医学会雑誌, 2021/01/25, Vol.58(1), pp.101-110 |
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