中国老年人失能现况及影响因素分析
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摘要
目的了解中国老年人失能现况及影响因素。方法利用2015年中国健康与养老追踪调查数据(CHARLS),选取≥60岁老年人群,采用躯体生活自理量表(PSMS)进行老年人失能状态的判定;应用logistic回归模型对老年人失能的影响因素进行分析。结果共纳入≥60岁老年人5 454人,其中失能老人543人,失能率为10.0%。女性的失能率(10.5%)高于男性的失能率(9.3%);多因素分析结果显示,年龄,社交活动频率,抑郁、慢病数量、自评健康状况是老年人失能的危险因素(P <0.05)。结论本研究显示,中国老年人失能情况严峻,应加强老年人的慢性病管理,提供高质量的专业性养老服务和长期护理服务;关注老年人心理健康,鼓励其进行适量的社交活动。
Objective To explore the prevalence and influencing factors of disability among the elderly in China.Methods Valid information for a total of 5 454 urban and rural residents aged ≥ 60 years were retrieved from the datasets of China Health and Retirement Longitudinal Study(CHARLS) 2015. The disability of the elderly was assessed with Physical Self-Maintenance Scale(PSMS). Chi-square test and logistic regression were applied to analyze the differences in disability among different groups and its influencing factors. Results For all the elderly, 543 were identified with disability and the prevalence rate of disability was 10.0%. The disability rate of the female elderly was higher than that of the males(10.5% vs. 9.3%). The results of multivariate logistic regression analysis revealed that elder age, decrease in frequency of social activity, depression, suffering from 3 or more chronic diseases, and poor self-rated health were the main risk factors for disability in the elderly(P < 0.05 for all). Conclusion The prevalence of disability was high among elderly residents in China and effective measures need to be implemented to promote healthy aging in the elderly population.
Objective To explore the prevalence and influencing factors of disability among the elderly in China.Methods Valid information for a total of 5 454 urban and rural residents aged ≥ 60 years were retrieved from the datasets of China Health and Retirement Longitudinal Study(CHARLS) 2015. The disability of the elderly was assessed with Physical Self-Maintenance Scale(PSMS). Chi-square test and logistic regression were applied to analyze the differences in disability among different groups and its influencing factors. Results For all the elderly, 543 were identified with disability and the prevalence rate of disability was 10.0%. The disability rate of the female elderly was higher than that of the males(10.5% vs. 9.3%). The results of multivariate logistic regression analysis revealed that elder age, decrease in frequency of social activity, depression, suffering from 3 or more chronic diseases, and poor self-rated health were the main risk factors for disability in the elderly(P < 0.05 for all). Conclusion The prevalence of disability was high among elderly residents in China and effective measures need to be implemented to promote healthy aging in the elderly population.
引文
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[25]Deimling GT,Pappada H,Ye M,et al.Factors affecting perceptions of disability and self-rated health among older adult,long-term cancer survivors[J].Journal of Aging and Health,2017,31(4):667-684.
[2]庄绪荣,张丽萍.失能老人养老状况分析[J].人口学刊,2016,38(03):47-57.
[3]丁百仁,王毅杰.由身至心:中国老年人的失能状态与幸福感[J].人口与发展,2017,23(5):82-90.
[4]Mlinaca ME,Feng MC.Assessment of activities of daily living,self-care,and independence[J].Archives of Clinical Neuropsychology,2016(31):506-516.
[5]杨付英,郝晓宁,薄涛,等.我国老年人失能现状及其影响因素分析-基于CHARLS数据的实证分析[J].卫生经济研究,2016(11):7-10.
[6]肖煜吟,徐月宾,陈洪涛,等.不同长期照护服务模式下的老年人失能状况比较研究[J].中国卫生资源,2018,21(2):144-148.
[7]陈炜,郝世超,茅范贞,等.厦门市老年人失能现状及其影响因素研究[J].中国卫生统计,2015,32(5):770-773.
[8]Duan J,Jiao F,Zhang Q,et al.Predicting urban medical services demand in China:an improved grey Markov chain model by Taylor approximation[J].Int J Environ Res Public Health,2017,14(8).
[9]Liu Y,Chen C,Jin G,et al.Reasons for encounter and health problems managed by general practitioners in the rural areas of Beijing,China:a cross-sectional study[J].PLoS One,2017,12(12):e0190036.
[10]Schultz-Larsen K,Rahmanfard N,Holst C.Physical activity(PA)and the disablement process:a 14-year follow-up study of older non-disabled women and men[J].Archives of Gerontology and Geriatrics,2012:25-30.
[11]Alexandre Tda S,Corona LP,Nunes DP,et al.Gender differences in incidence and determinants of disability in activities of daily living among elderly individuals:SABE study[J].Arch.Gerontol.Geriatr,2012,55(2):431-437.
[12]魏蒙,王红漫,王晓军.中国不同特征老年人失能轨迹差异分析[J].中国公共卫生,2017,33(12):1689-1692.
[13]周绪凤,马亚娜.中国农村老年人失能状况及影响因素分析[J].中国公共卫生,2017,33(11):1665-1668.
[14]Zhou S,Zhou R,Zhong T,et al.Association of smoking and alcohol drinking with dementia risk among elderly men in China[J].Current Alzheimer Research,2014,11(9):874-876.
[15]Towers A,Philipp M,Dulin P,et al.The"health benefits"of moderate drinking in older adults may be better explained by socioeconomic status[J].Journals of Gerontology:Social Sciences,2018,73(4):649-654.
[16]Hirst JA,Aronson JK,Feakins BG,et al.Short-and medium-term effects of light to moderate alcohol intake on glycaemic control in diabetes mellitus:a systematic review and meta-analysis of randomized trials[J].Diabet Med,2017,34(5):604-611.
[17]Minagawa Y,Saito Y.Active Social Participation and mortality risk among older people in Japan:results from a nationally representative sample[J].Research on Aging,2015,37(5):481-499.
[18]Ballert CS,Hopfe M,Kus S,et al.Using the refined ICF Linking Rules to compare the content of existing instruments and assessments:a systematic review and exemplary analysis of instruments measuring participation[J].Disability and Rehabilitation,2019,41(5):584-600.
[19]Jerliu N,Burazeri G,Toci E,et al.Social networks,social participation and self-perceived health among older people in transitional Kosovo[J].European Journal of Public Health,2014,24(2):333-337.
[20]安思琪,陈长香,李建民,等.高龄失能老年人人生态度和人格型态与衰弱程度相关性[J].中国公共卫生,2018,34(2):171-176.
[21]Basu S,King AC.Disability and chronic disease among older adults in India:detecting vulnerable populations through the WHOSAGE study[J].American Journal of Epidemiology,2013,178(11):1620-1628.
[22]Yokota RT,Berger N,Nusselder WJ,et al.Contribution of chronic diseases to the disability burden in a population 15 years and older,Belgium,1997-2008[J].BMC Public Health,2015,15:229.
[23]Klijs B,Nusselder WJ,Looman CW,et al.Contribution of chronic disease to the burden of disability[J].PLoS One,2011,6(9):e25325.
[24]Abuladze L,Kunder N,Lang K,et al.Associations between selfrated health and health behaviour among older adults in Estonia:a cross-sectional analysis[J].BMJ Open,2017,7:e013257.
[25]Deimling GT,Pappada H,Ye M,et al.Factors affecting perceptions of disability and self-rated health among older adult,long-term cancer survivors[J].Journal of Aging and Health,2017,31(4):667-684.