长寿时代我国百岁老人健康指标变化趋势探究——基于CLHLS数据的验证
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摘要
随着平均预期寿命不断延长及人口年龄结构的嬗变,中国进入了长寿时代。目前,健康长寿成为学界关注的热门议题,并且学界开始关注长寿时代高龄老人的健康指标变化特征及趋势。为了实现健康老龄化,进一步增进老年人生活福祉,利用中国老龄健康影响因素跟踪调查(CLHLS)数据,从队列的视角出发,采用日常生活自理能力(ADL)、工具性日常生活自理能力(IADL)、自评健康(SRH)、认知能力(MMSE)、精神健康(MH)、虚弱指数(FI)六项指标来探究同一队列高龄老人的健康状况随时间的变动趋势(91～106岁的变化趋势),并比较90岁以上高龄老人与百岁老人之间的健康状况差异。研究结果显示,虽然高龄老人和百岁老人群体中女性老人的比重大于男性,但男性老年人的健康状况总体上要好于女性老年人,在90岁高龄老人到百岁老人的健康变化发展中,"选择性生存"效应明显。
With the increasing average life expectancy and age structure transformation, China has shifted into an era of longevity. Nowadays, health and longevity have become a heated topic in academic communities,and scholars have begun to pay attention to the characteristics and trends of health indicators of the elderly in the era of longevity. In order to explore ways to achieve the healthy aging and further improve the well-being of the elderly, this paper, based on the CLHLS data, adopts six indicators, which are activities of daily life,instrumental activities of daily life, self-rated health, mini-mental state examination, mental health and frailty index, to explore the changing trend of health status over time (from 91 to 106 years old) in the same cohort. The paper also compares the health conditions between the elderly over 90 years old and the centenarians. The results show that although the proportion of female elderly is larger than that of the male, the health status of the male elderly is generally better than that of the female elderly. In the process of health change from 90-year-old to 100-year-old, the "selective survival" effect is obvious.
With the increasing average life expectancy and age structure transformation, China has shifted into an era of longevity. Nowadays, health and longevity have become a heated topic in academic communities,and scholars have begun to pay attention to the characteristics and trends of health indicators of the elderly in the era of longevity. In order to explore ways to achieve the healthy aging and further improve the well-being of the elderly, this paper, based on the CLHLS data, adopts six indicators, which are activities of daily life,instrumental activities of daily life, self-rated health, mini-mental state examination, mental health and frailty index, to explore the changing trend of health status over time (from 91 to 106 years old) in the same cohort. The paper also compares the health conditions between the elderly over 90 years old and the centenarians. The results show that although the proportion of female elderly is larger than that of the male, the health status of the male elderly is generally better than that of the female elderly. In the process of health change from 90-year-old to 100-year-old, the "selective survival" effect is obvious.
引文
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[2]姜向群,魏蒙,张文娟.中国老年人口的健康状况及影响因素研究[J].人口学刊,2015(2):46-56.
[3]曾毅,顾大男,JAMA PURSER,等.社会、经济与环境因素对老年健康和死亡的影响---基于中国22省份的抽样调查[J].中国卫生政策研究,2014(6):53-62.
[4]齐亚强.自评一般健康的信度和效度分析[J].社会,2014(6):196-215.
[5]LEVERS M J,ESTABROOKS C A,ROSS KERR J C.Factors contributing to frailty:literature review[J].Journal of Advanced Nursing,2006(3):282-291.
[6]樊新民.中国第六次人口普查长寿人口研究[J].人口学刊,2013(4):14-20.
[7]樊新民.中国长寿人口分布研究[J].人口学刊,2006(3):19-23.
[8]央吉.论中国广西巴马长寿带及其生存环境[J].中国人口科学,1994(2):6-12.
[9]邬沧萍,徐勤.对百岁老年人口实证研究的思考[J].中国人口科学,1999(6):42-46.
[10]国凯,尹志娟,周成超,等.山东省长寿地区百岁老人生活方式与慢性病的关系[J].山东大学学报(医学版),2014(1):109-112.
[11]肖振禹,徐勤,原野.巴马百岁老人状况及长寿原因探讨[J].中国人口科学,1996(3):27-32.
[12]楚军红,柳玉芝.中国的百岁老人[J].人口与经济,2001(4):29-35.
[13]樊新民.高龄老人健康长寿因素研究[J].人口学刊,2007(6):13-17.
[14]翟德华,陶立群.高龄老人性格心理特征、饮食习惯与健康长寿关系研究[J].中国人口科学,2004(S1):83-87+177.
[15]顾大男.婚姻对中国高龄老人健康长寿影响的性别差异分析[J].中国人口科学,2003(3):36-44.
[16]张纯元.高龄老人受教育程度与健康长寿关系研究[J].南方人口,2001(3):1-5.
[17]曲嘉瑶,杜鹏.中国城镇老年人的居住意愿对空巢居住的影响[J].人口与发展,2014(2):87-94.
[18]张丽萍.老年人口居住安排与居住意愿研究[J].人口学刊,2012(6):25-33.
[19]郭志刚.中国高龄老人的居住方式及其影响因素[J].人口研究,2002(1):37-42.
[20]张震.中国高龄老人居住方式的影响因素研究[J].中国人口科学,2001(S1):73-79.
[21]SIEGEL J S,PASSEL J S.New estimates of the number of centenarians in the United States[J].Journal of the American Statistical Association,1976(355):559-566.
[22]WANG Z,ZENG Y I,VAUPEL B J W.Age validation of han Chinese centenarians[J].Genus,1998(1-2):123-141.
[23]GOMES M M F,TURRA C M.The number of centenarians in Brazil:indirect estimates based on death certificates[J].Demographic Research,2009(20):495-502.
[24]EVANS C J,HO Y,DAVESON B A,ET AL.Place and cause of death in centenarians:a population-based observational study in England,2001 to 2010[J].PLoS Medicine,2014(6):e1001653.
[25]RIBEIRO O,TEIXEIRA L,ARAUJO L,ET AL.Health profile of centenarians in portugal:a census-based approach[J].Population Health Metrics,2016(1):13.
[26]ROBINE J M,CASELLI G.An unprecedented increase in the number of centenarians[J].Genus,2005(1):57-82.
[27]ANSON J.Surviving to be the oldest old-destiny or chance?[J].Vienna Yearbook of Population Research,2013(11):71-85.
[28]ROBINE J M,PACCAUD F.Nonagenarians and centenarians in Switzerland,1860-2001:a demographic analysis[J].Journal of Epidemiology&Community Health,2005(1):31-37.
[29]PEDRO VALDS-CORCHADO,ARTURO RUIZ-HERNNDEZ,ALEJANDRO PREZ-MORENO,ET AL.Sociodemographic and clinical characteristics of centenarians in mexico city[J].BioMed Research International,2017,2017:1-7.
[30]YANG P S.Surviving social support:care challenges facing Taiwanese centenarians[J].International Journal of Social Welfare,2013(4):396-405.
[31]ISHIOKA Y L,GONDO Y,FUKU N,ET AL.Effects of the APOEε4 allele and education on cognitive function in Japanese centenarians[J].AGE,2016(5-6):495-503.
[32]杜本峰,王旋.老年人健康不平等的演化、区域差异与影响因素分析[J].人口研究,2013(5):81-90.
[33]李婷,张闫龙.出生队列效应下老年人健康指标的生长曲线及其城乡差异[J].人口研究,2014(2):18-35.
[34]MA S,SM Z,SMZ A S N,ET AL.Systematic review on the functional status of elderly hip fracture patients using katz index of activity of daily living(katz adl)score[J].International Medical Journal Malaysia,2016(2):89-99.
[35]ZHANG Z.Gender differentials in cognitive impairment and decline of the oldest old in China[J].The Journals of Gerontology Series B:Psychological Sciences and Social Sciences,2006(2):S107-S115.
[36]FAYERS P M,SPRANGERS M A G.Understanding self-rated health[J].The Lancet,2002(359):187-188.
[37]陆杰华,郭冉.基于地区和社区视角下老年健康与不平等的实证分析[J].人口学刊,2017(2):57-67.
[38]曾宪新.老年健康综合指标---虚弱指数研究进展[J].中国老年学杂志,2010(21):3220-3223.
[39]MITNITSKI A,COLLERTON J,MARTIN-RUIZ C,ET AL.Age-related frailty and its association with biological markers of ageing[J].BMC Medicine,2015(1):161.
[40]ROCKWOOD K.A global clinical measure of fitness and frailty in elderly people[J].Canadian Medical Association Journal,2005(5):489-495.
[41]顾大男,曾毅,柳玉芝,等.中国老年人虚弱指数及其与痛苦死亡的关系研究[J].人口研究,2007(5):35-41.
[42]梁荫基.虚弱指数在老年人健康评估中的应用及研究进展[J].中华护理杂志,2010(12):1144-1 146.
[43]陆杰华,李月,郑冰.中国大陆老年人社会参与和自评健康相互影响关系的实证分析---基于CLHLS数据的检验[J].人口研究,2017(1):15-26.
[44]张莉.中国高龄老人的居住安排、代际关系和主观幸福感---基于对CLHLS数据的分析[J].国家行政学院学报,2015(5):68-73.
[45]ADKINS G,MARTIN P,POON L W.Personality traits and states as predictors of subjective wellbeing in centenarians,octogenarians,and sexagenarians[J].Psychology and Aging,1996(3):408.
[46]JOPP D,ROTT C.Adaptation in very old age:Exploring the role of resources,beliefs,and attitudes for centenarians'happiness[J].Psychology and Aging,2006(2):266.
[47]杜旻.社会支持对老年人心理健康的影响研究[J].人口与社会,2017(4):12-19.
[48]彭大松,张卫阳,王承宽.流动老人的心理健康及影响因素分析---基于南京的调查发现[J].人口与社会,2017(4):20-32.
[49]WAIDMANN T,SCHOENBAUM B M.The illusion of failure:trends in the self-reported health of the U.S.elderly[J].The Milbank Quarterly,1995(2):253-287.
[2]姜向群,魏蒙,张文娟.中国老年人口的健康状况及影响因素研究[J].人口学刊,2015(2):46-56.
[3]曾毅,顾大男,JAMA PURSER,等.社会、经济与环境因素对老年健康和死亡的影响---基于中国22省份的抽样调查[J].中国卫生政策研究,2014(6):53-62.
[4]齐亚强.自评一般健康的信度和效度分析[J].社会,2014(6):196-215.
[5]LEVERS M J,ESTABROOKS C A,ROSS KERR J C.Factors contributing to frailty:literature review[J].Journal of Advanced Nursing,2006(3):282-291.
[6]樊新民.中国第六次人口普查长寿人口研究[J].人口学刊,2013(4):14-20.
[7]樊新民.中国长寿人口分布研究[J].人口学刊,2006(3):19-23.
[8]央吉.论中国广西巴马长寿带及其生存环境[J].中国人口科学,1994(2):6-12.
[9]邬沧萍,徐勤.对百岁老年人口实证研究的思考[J].中国人口科学,1999(6):42-46.
[10]国凯,尹志娟,周成超,等.山东省长寿地区百岁老人生活方式与慢性病的关系[J].山东大学学报(医学版),2014(1):109-112.
[11]肖振禹,徐勤,原野.巴马百岁老人状况及长寿原因探讨[J].中国人口科学,1996(3):27-32.
[12]楚军红,柳玉芝.中国的百岁老人[J].人口与经济,2001(4):29-35.
[13]樊新民.高龄老人健康长寿因素研究[J].人口学刊,2007(6):13-17.
[14]翟德华,陶立群.高龄老人性格心理特征、饮食习惯与健康长寿关系研究[J].中国人口科学,2004(S1):83-87+177.
[15]顾大男.婚姻对中国高龄老人健康长寿影响的性别差异分析[J].中国人口科学,2003(3):36-44.
[16]张纯元.高龄老人受教育程度与健康长寿关系研究[J].南方人口,2001(3):1-5.
[17]曲嘉瑶,杜鹏.中国城镇老年人的居住意愿对空巢居住的影响[J].人口与发展,2014(2):87-94.
[18]张丽萍.老年人口居住安排与居住意愿研究[J].人口学刊,2012(6):25-33.
[19]郭志刚.中国高龄老人的居住方式及其影响因素[J].人口研究,2002(1):37-42.
[20]张震.中国高龄老人居住方式的影响因素研究[J].中国人口科学,2001(S1):73-79.
[21]SIEGEL J S,PASSEL J S.New estimates of the number of centenarians in the United States[J].Journal of the American Statistical Association,1976(355):559-566.
[22]WANG Z,ZENG Y I,VAUPEL B J W.Age validation of han Chinese centenarians[J].Genus,1998(1-2):123-141.
[23]GOMES M M F,TURRA C M.The number of centenarians in Brazil:indirect estimates based on death certificates[J].Demographic Research,2009(20):495-502.
[24]EVANS C J,HO Y,DAVESON B A,ET AL.Place and cause of death in centenarians:a population-based observational study in England,2001 to 2010[J].PLoS Medicine,2014(6):e1001653.
[25]RIBEIRO O,TEIXEIRA L,ARAUJO L,ET AL.Health profile of centenarians in portugal:a census-based approach[J].Population Health Metrics,2016(1):13.
[26]ROBINE J M,CASELLI G.An unprecedented increase in the number of centenarians[J].Genus,2005(1):57-82.
[27]ANSON J.Surviving to be the oldest old-destiny or chance?[J].Vienna Yearbook of Population Research,2013(11):71-85.
[28]ROBINE J M,PACCAUD F.Nonagenarians and centenarians in Switzerland,1860-2001:a demographic analysis[J].Journal of Epidemiology&Community Health,2005(1):31-37.
[29]PEDRO VALDS-CORCHADO,ARTURO RUIZ-HERNNDEZ,ALEJANDRO PREZ-MORENO,ET AL.Sociodemographic and clinical characteristics of centenarians in mexico city[J].BioMed Research International,2017,2017:1-7.
[30]YANG P S.Surviving social support:care challenges facing Taiwanese centenarians[J].International Journal of Social Welfare,2013(4):396-405.
[31]ISHIOKA Y L,GONDO Y,FUKU N,ET AL.Effects of the APOEε4 allele and education on cognitive function in Japanese centenarians[J].AGE,2016(5-6):495-503.
[32]杜本峰,王旋.老年人健康不平等的演化、区域差异与影响因素分析[J].人口研究,2013(5):81-90.
[33]李婷,张闫龙.出生队列效应下老年人健康指标的生长曲线及其城乡差异[J].人口研究,2014(2):18-35.
[34]MA S,SM Z,SMZ A S N,ET AL.Systematic review on the functional status of elderly hip fracture patients using katz index of activity of daily living(katz adl)score[J].International Medical Journal Malaysia,2016(2):89-99.
[35]ZHANG Z.Gender differentials in cognitive impairment and decline of the oldest old in China[J].The Journals of Gerontology Series B:Psychological Sciences and Social Sciences,2006(2):S107-S115.
[36]FAYERS P M,SPRANGERS M A G.Understanding self-rated health[J].The Lancet,2002(359):187-188.
[37]陆杰华,郭冉.基于地区和社区视角下老年健康与不平等的实证分析[J].人口学刊,2017(2):57-67.
[38]曾宪新.老年健康综合指标---虚弱指数研究进展[J].中国老年学杂志,2010(21):3220-3223.
[39]MITNITSKI A,COLLERTON J,MARTIN-RUIZ C,ET AL.Age-related frailty and its association with biological markers of ageing[J].BMC Medicine,2015(1):161.
[40]ROCKWOOD K.A global clinical measure of fitness and frailty in elderly people[J].Canadian Medical Association Journal,2005(5):489-495.
[41]顾大男,曾毅,柳玉芝,等.中国老年人虚弱指数及其与痛苦死亡的关系研究[J].人口研究,2007(5):35-41.
[42]梁荫基.虚弱指数在老年人健康评估中的应用及研究进展[J].中华护理杂志,2010(12):1144-1 146.
[43]陆杰华,李月,郑冰.中国大陆老年人社会参与和自评健康相互影响关系的实证分析---基于CLHLS数据的检验[J].人口研究,2017(1):15-26.
[44]张莉.中国高龄老人的居住安排、代际关系和主观幸福感---基于对CLHLS数据的分析[J].国家行政学院学报,2015(5):68-73.
[45]ADKINS G,MARTIN P,POON L W.Personality traits and states as predictors of subjective wellbeing in centenarians,octogenarians,and sexagenarians[J].Psychology and Aging,1996(3):408.
[46]JOPP D,ROTT C.Adaptation in very old age:Exploring the role of resources,beliefs,and attitudes for centenarians'happiness[J].Psychology and Aging,2006(2):266.
[47]杜旻.社会支持对老年人心理健康的影响研究[J].人口与社会,2017(4):12-19.
[48]彭大松,张卫阳,王承宽.流动老人的心理健康及影响因素分析---基于南京的调查发现[J].人口与社会,2017(4):20-32.
[49]WAIDMANN T,SCHOENBAUM B M.The illusion of failure:trends in the self-reported health of the U.S.elderly[J].The Milbank Quarterly,1995(2):253-287.