Functional disability and cognition in relation to residential transitions in older adults: Evidence from three French cohorts, 1988-2018.

IF 3.2 Q2 GERIATRICS & GERONTOLOGY

Journal of Frailty & Aging Pub Date : 2026-06-01 Epub Date: 2026-05-24 DOI:10.1016/j.tjfa.2026.100159

Jeanne Bardinet, Luc Letenneur, Alice Pellichero, Denis Boucaud-Maitre, Maturin Tabue-Teguo, Hélène Amieva, Karine Pérès

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引用次数: 0

Abstract

Background: Aging is often accompanied by increasing difficulties in daily living that may compromise aging in place. In France, three main housing types can be distinguished: ordinary home (OH), intermediate housing (IH) and nursing home (NH). This study aimed to explore the relationship between functional disability, cognition, and residential transitions in older adults.

Methods: Participants aged 65 years and older living in OH at baseline were drawn from three French population-based cohorts (PAQUID, Three-City and AMI), followed for up to 30 years. A hierarchical indicator of functional disability was derived from mobility, IADL and ADL disabilities, while cognitive function was assessed using the Mini Mental State Examination (MMSE). A multi-state model was applied to investigate the associations between functional disability and cognition (as time-dependent variables) with housing transitions, adjusting for sex, cohort, marital status and education. We also examined the involvement of IADL disabilities on transitions from OH to IH or NH in sex-stratified models. Sensitivity analyses were performed using lagged measures.

Results: Among 5264 included participants (mean age 74.7 ± 6.0 years; 56.9% women), 832 relocated from OH during a median follow-up of 10.2 years, including 216 to IH and 616 to NH. Mild and moderate disability, as lower MMSE scores, were independently associated with higher risks of transitioning to IH or NH, while severe disability and cognitive impairment were only associated with NH transitions. In sex-stratified analyses, transportation difficulties were associated with IH and NH transitions among women, whereas only with NH admission in men. Difficulties with handling finances in women, with medications management in men, and difficulties with shopping in both sexes were also associated with transition to NH.

Discussion: Intermediate housing was more frequently associated with mild or moderate disability, whereas transitions to long-term care were more often observed in participants with severe cognitive decline.

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老年人居住转换相关的功能残疾和认知：来自三个法国队列的证据，1988-2018。

背景：衰老通常伴随着日常生活中越来越多的困难，这些困难可能会影响到现有的衰老。在法国，可以区分出三种主要的住房类型：普通住房（OH）、中等住房（IH）和养老院（NH）。本研究旨在探讨老年人功能障碍、认知和居住转变之间的关系。方法：从三个以法国人口为基础的队列（PAQUID， three - city和AMI）中抽取65岁及以上的基线生活在OH中的参与者，随访长达30年。功能障碍的分级指标由活动能力、IADL和ADL残疾得出，而认知功能则使用迷你精神状态检查（MMSE）进行评估。应用多状态模型研究了功能障碍和认知（作为时间相关变量）与住房转换之间的关系，调整了性别、队列、婚姻状况和教育程度。我们还在性别分层模型中研究了IADL残疾对从OH到IH或NH转变的影响。使用滞后测量进行敏感性分析。结果：5264名参与者（平均年龄74.7±6.0岁，56.9%为女性），832人在10.2年的中位随访期间从OH转移，其中216人转移到IH， 616人转移到NH。轻度和中度残疾，作为较低的MMSE评分，与过渡到IH或NH的高风险独立相关，而重度残疾和认知障碍仅与NH过渡相关。在性别分层分析中，交通困难与女性的IH和NH转变有关，而仅与男性的NH入院有关。女性的财务困难，男性的药物管理困难，以及两性的购物困难也与向NH的过渡有关。讨论：中间住房更常与轻度或中度残疾相关，而过渡到长期护理更常发生在认知能力严重下降的参与者身上。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-

CiteScore

5.90

自引率

7.70%

发文量

期刊介绍： The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).