上海市嘉定区社区老年人的失能现状及其影响因素

张妍; 袁红; 金亚清; 于宏杰

doi:10.16462/j.cnki.zhjbkz.2022.07.007

上海市嘉定区社区老年人的失能现状及其影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.07.007

201899 上海，上海市嘉定区疾病预防控制中心综合办

基金项目:

2021―2022年上海市疾病预防控制青年骨干人才培养项目 21QNGG22

详细信息

通讯作者:
张妍，E-mail: 605235506@qq.com

中图分类号: R161.7
计量
- 文章访问数: 335
- HTML全文浏览量: 147
- PDF下载量: 64
- 被引次数: 0
出版历程
- 收稿日期: 2021-08-26
- 修回日期: 2022-03-03
- 网络出版日期: 2022-07-19
- 刊出日期: 2022-07-10

Disability status and its influencing factors of the elderly in Jiading District, Shanghai

General Affairs Office, Jiading District Center for Disease Control and Prevention, Shanghai 201899, China

Funds:

Key Young Talents Training Program for Disease Prevention and Control of Shanghai, 2021-2022 21QNGG22

More Information

Corresponding author: ZHANG Yan, E-mail: 605235506@qq.com

摘要

摘要: 目的了解上海市嘉定区老年人的失能现状并分析其影响因素，为老年人失能防控和健康老龄化建设提供科学依据。方法采用多阶段随机抽样方法，选取≥60岁的嘉定区户籍老年人群作为调查对象，采用世界卫生组织研发的自报健康调查量表测量老年人失能情况；应用多因素Logistic回归分析模型及列线图分析老年人失能的影响因素。结果共调查老年人4 773人，其中失能老人495人，失能率为11.4%，女性的失能率(13.6%)高于男性(8.9%)。老年人自我评价在认知记忆、视力辨认、疼痛不适、睡眠及活动行走这五方面存在更多的失能，失能率分别为31.7%、23.0%、21.6%、20.4%和13.6%。多因素分析结果显示，年龄大、自评健康较差、患2种及以上慢性病的老年人失能率较高(均有P＜0.05)；每周体育锻炼、饮酒的老年人失能率较低(均有P＜0.05)。结论嘉定区社区老年人失能率较高。应加强慢性病管理，关注老年人的不同照护需求，开展针对性的早期预防和干预。
- 失能 /
- 老年人 /
- 影响因素 /
- 列线图
Abstract: Objective To investigate the status and its influencing factors of disability among the elderly population in Jiading District, Shanghai, and to provide scientific basis for the prevention and control of disability and the construction of healthy aging. Methods A multi-stage random sampling method was used to select the elderly population aged ≥60 years old in Jiading District. The World Health Survey scale conducted by WHO was used to measure the disability of the elderly. Multivariate Logistic regression model and nomogram were used to analyze the influencing factors of disability. Results A total of 4 773 elderly people were investigated, including 495 disabled elderly people, with a disability rate of 11.4%. The disability rate was higher in women (13.6%) than that in men (8.9%). The elderly had more disability in cognitive memory (31.7%), visual recognition (23.0%), pain and discomfort (21.6%), sleep (20.4%) and walking (13.6%). Multivariate analysis showed that aging, poor self-rated health and with two or more chronic diseases were associated with higher rates of disability (all P < 0.05). Weekly physical exercises and drinking were associated with lower rates of disability (all P < 0.05). Conclusions The disability rate of the elderly in Jiading District is high. The government should strength the chronic disease management, pay attention to the different care needs of the elderly, and carry out targeted early prevention and intervention.
- Disability /
- The elderly /
- Influencing factor /
- Nomogram

HTML全文

图 1 预测老年人失能发生的列线图模型

Figure 1. Nomogram for the elderly to predict the occurrence of disability

下载: 全尺寸图片幻灯片

图 2 老年人发生失能风险预测列线图的内部交叉验证

Figure 2. Internal cross-validation of the nomogram model for predicting risk of disability in the elderly

下载: 全尺寸图片幻灯片

表 1 不同特征的嘉定区老年人失能率比较[n(%)]

Table 1. Comparison of disability rates among the elderly with different characteristics in Jiading District [n(%)]

项目	调查人数	失能人数	χ²/χ²趋势值	P值	项目	调查人数	失能人数	χ²/χ²趋势值	P值
年龄(岁)			182.737	＜0.001	文化程度			65.798	＜0.001
60~＜70	2 623	202 (7.7)			小学及以下	1 811	289 (16.0)
70~＜80	1 328	172 (13.0)			初中	1 721	144 (8.4)
80~98	396	121 (30.6)			高中/中专	609	42 (6.9)
性别			23.927	＜0.001	大专及以上	206	20 (9.7)
男	2 074	185 (8.9)			每周体育锻炼			114.710	＜0.001
女	2 273	310 (13.6)			是	2 812	213 (7.6)
婚姻状况			35.226	＜0.001	否	1 535	282 (18.4)
已婚	3 578	360 (10.1)			每天睡眠时间(h)			11.971	＜0.001
离异/丧偶/未婚	769	135 (17.6)			＜7	1 675	226 (13.5)
家庭年收入(万元)			1.580	0.454	≥7	2 672	269 (10.1)
＜10	2 655	351 (11.7)			自评健康状况			244.699	＜0.001
10~＜20	951	119 (11.1)			良好	1 804	44 (2.4)
≥20	246	25 (9.2)			较差	2 543	451 (17.1)
吸烟			23.779	＜0.001	慢性病患病种数(种)			247.347	＜0.001
是	1 507	123 (8.2)			0	922	41 (4.4)
否	2 840	372 (13.1)			1	1 378	86 (6.2)
饮酒			32.917	＜0.001	2	1 082	137 (12.7)
是	976	61 (6.2)			3	552	102 (18.4)
否	3 371	434 (12.9)			≥4	411	129 (31.4)

下载: 导出CSV

表 2 不同特征老人在不同维度具有中度以上困难或问题情况[n(%)]

Table 2. The characteristics of the elderly with moderate or more difficulties or problems in different dimensions [n(%)]

失能维度	失能人数	年龄(岁)					性别
失能维度	失能人数	60~＜70	70~＜80	80~98	χ²/χ²趋势值	P值	男	女	χ²/χ²趋势值	P值
认知记忆	1 379 (31.7)	674 (25.7)	506 (38.1)	199 (50.3)	131.683	＜0.001	523 (25.2)	856 (37.7)	77.515	＜0.001
视力辨认	999 (23.0)	479 (18.3)	357 (26.9)	163 (41.2)	115.296	＜0.001	380 (18.3)	619 (27.2)	48.648	＜0.001
疼痛不适	939 (21.6)	480 (18.3)	335 (25.2)	124 (31.3)	49.160	＜0.001	317 (15.3)	622 (27.4)	93.451	＜0.001
睡眠精力	888 (20.4)	491 (18.7)	287 (21.6)	110 (27.8)	17.899	＜0.001	285 (13.7)	603 (26.5)	109.091	＜0.001
活动行走	590 (13.6)	232 (8.8)	229 (17.2)	129 (32.6)	180.184	＜0.001	224 (10.8)	366 (16.1)	25.986	＜0.001
抑郁焦虑	344 (7.9)	191 (7.3)	110 (8.3)	43 (10.9)	5.823	0.016	109 (5.3)	235 (10.3)	38.453	＜0.001
自理照顾	188 (4.3)	57 (2.2)	60 (4.5)	71 (17.9)	156.558	＜0.001	72 (3.5)	116 (5.1)	6.979	0.008
人际活动	150 (3.5)	62 (2.4)	50 (3.8)	38 (9.6)	44.623	＜0.001	58 (2.8)	92 (4.0)	5.094	0.024

下载: 导出CSV

表 3 嘉定区老年人失能影响因素的Logistic回归分析模型分析

Table 3. Logistic regression analysis of influencing factors of disability in the elderly in Jiading District

自变量	β值	s_x值	Wald值	OR(95% CI)值	P值	自变量	β值	s_x值	Wald值	OR(95% CI)值	P值
年龄(岁)						饮酒
60~＜70				1.000		否				1.000
70~＜80	0.322	0.120	7.161	1.380(1.090~1.747)	0.007	是	-0.439	0.167	6.916	0.644(0.465~0.894)	0.009
80~98	1.198	0.159	56.719	3.313(2.426~4.524)	＜0.001	每周体育锻炼
性别						否				1.000
男				1.000		是	-0.844	0.106	63.362	0.430(0.349~0.529)	＜0.001
女	-0.140	0.164	0.731	0.869(0.630~1.199)	0.392	每天睡眠时间(h)
文化程度						≥7				1.000
大专及以上				1.000		＜7	0.015	0.107	0.020	1.015(0.823~1.252)	0.888
小学及以下	0.209	0.275	0.581	1.233(0.720~2.113)	0.446	自评健康
初中	-0.121	0.281	0.187	0.886(0.511~1.535)	0.665	良好				1.000
高中/中专	-0.294	0.314	0.878	0.745(0.403~1.379)	0.349	较差	1.809	0.169	115.271	6.105(4.388~8.495)	＜0.001
婚姻状况						慢性病患病种数(种)
已婚				1.000		0				1.000
离异/丧偶/未婚	0.049	0.130	0.139	1.050(0.813~1.356)	0.709	1	0.084	0.204	0.171	1.088(0.729~1.623)	0.679
吸烟						2	0.565	0.196	8.343	1.759(1.199~2.581)	0.004
否				1.000		3	0.863	0.207	17.331	2.371(1.579~3.561)	＜0.001
是	-0.271	0.175	2.404	0.762(0.541~1.074)	0.121	≥4	1.424	0.207	47.334	4.153(2.768~6.230)	＜0.001

下载: 导出CSV

参考文献(18)

[1]	国家统计局. 第七次全国人口普查公报(第五号)[EB/OL]. (2021-05-11)[2021-06-22]. http://www.stats.gov.cn/ztjc/zdtjgz/zgrkpc/dqcrkpc/ggl/202105/t20210519_1817698.html. National Bureau of Statistics. Bulletin of the Seventh National Population Census (No. 5)[EB/OL]. (2021-05-11)[2021-06-22]. http://www.stats.gov.cn/ztjc/zdtjgz/zgrkpc/dqcrkpc/ggl/202105/t20210519_1817698.html.
[2]	张良文, 方亚. 2020-2050年我国城乡老年人失能规模及其照护成本的预测研究[J]. 中国卫生统计, 2021, 38(1): 39-42. DOI: 10.3969/j.issn.1002-3674.2021.01.010. Zhang LW, Fang Y. Predictive study of disability scale and care cost of the elderly in urban and rural China from 2020 to 2050[J]. Chin J Health Statistics, 2021, 38(1): 39-42. DOI: 10.3969/j.issn.1002-3674.2021.01.010.
[3]	Fong JH. Disability incidence and functional decline among older adults with major chronic diseases[J]. BMC Geriatr, 2019, 19(1): 323. DOI: 10.1186/s12877-019-1348-z.
[4]	Lestari SK, Ng N, Kowal P, et al. Diversity in the factors associated with ADL-related disability among older people in six middle-income countries: a cross-country comparison[J]. Int J Environ Res Public Health, 2019, 16(8): 1341. DOI: 10.3390/ijerph16081341.
[5]	张妍, 袁红, 金亚清, 等. 嘉定区居民自评健康状况及影响因素分析[J]. 预防医学, 2020, 32(9): 954-958. DOI: 10.19485/j.cnki.issn2096-5087.2020.09.025. Zhang Y, Yuan H, Jin YQ, et al. Self-rated health status and influencing factors among residents in Jiading District[J]. Prev Med, 2020, 32(9): 954-958. DOI: 10.19485/j.cnki.issn2096-5087.2020.09.025.
[6]	钱军程, 陈育德, 饶克勤, 等. 中国老年人口失能流行趋势的分析与建议[J]. 中国卫生统计, 2012, 29(1): 6-9. DOI: 10.3969/j.issn.1002-3674.2012.01.002. Qian JC, Chen YD, Rao KQ, et al. Trends analysis and prediction on disability of China Mainland aging population and policy suggestion[J]. Chin J Health Statistics, 2012, 29(1): 6-9. DOI: 10.3969/j.issn.1002-3674.2012.01.002.
[7]	Ustun T, Chatterji S, Villanueva M, et al. The WHO Multi-country Household Survey Study on Health and Responsiveness 2000-2001. Health systems performance assessment——debates, methods and empiricism[M]. Geneva: WHO, 2003.
[8]	郭秀云. 上海老年人口失能水平与平均照料时间研究——基于多个数据来源的考察[J]. 南方人口, 2019, 34(3): 1-12. DOI: 10.3969/j.issn.1004-1613.2019.03.001. Guo XY. A study of the disability level and average care time of the daily living of Shanghai elderly based on multiple data sources[J]. Population in Southern China, 2019, 34(3): 1-12. DOI: 10.3969/j.issn.1004-1613.2019.03.001.
[9]	上海市统计局. 2020年上海统计年鉴[EB/OL]. (2020-06-29)[2021-06-22]. http://tjj.sh.gov.cn/tjnj/index.html. Shanghai Statistical Bureau. Shanghai Statistical Yearbook 2020[EB/OL]. (2020-06-29)[2021-06-22]. http://tjj.sh.gov.cn/tjnj/index.html.
[10]	周滢, 甘珊, 李峥. 社区老年人主观认知下降现状及影响因素分析[J]. 解放军护理杂志, 2021, 38(4): 21-24. DOI: 10.3969/j.issn.1008-9993.2021.04.006. Zhou Y, Gan S, Li Z. Status quo of subjective cognitive decline and its influencing factors among community-dwelling elder adults[J]. Nurs J Chin PLA, 2021, 38(4): 21-24. DOI: 10.3969/j.issn.1008-9993.2021.04.006.
[11]	Molinuevo JL, Rabin LA, Amariglio R, et al. Implementation of subjective cognitive decline criteria in research studies[J]. Alzheimers Dement, 2017, 13(3): 296-311. DOI: 10.1016/j.jalz.2016.09.012.
[12]	朱雪雪, 张玉, 刘宏宇, 等. 中国老年人失能现况及影响因素分析[J]. 中国公共卫生, 2019, 35(7): 914-917. DOI: 10.11847/zgggws1119829. Zhu XX, Zhang Y, Liu HY, et al. Prevalence and influencing factors of disability among the elderly in China[J]. Chin J Public Health, 2019, 35(7): 914-917. DOI: 10.11847/zgggws1119829.
[13]	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]. J Aging Health, 2019, 31(4): 667-684. DOI: 10.1177/0898264317745745.
[14]	蒋芝月, 李语眉, 王秀红, 等. 居家老年人常见慢性病与失能关系的病例对照研究[J]. 中国全科医学, 2019, 22(13): 1587-1591. DOI: 10.12114/j.issn.1007-9572.2019.00.111. Jiang ZY, Li YM, Wang XH, et al. Relationship between common chronic diseases and disability among the elderly with in-home care: a case-control study[J]. Chin J Gen Pract, 2019, 22(13): 1587-1591. DOI: 10.12114/j.issn.1007-9572.2019.00.111.
[15]	Balzi D, Lauretani F, Barchielli A, et al. Risk factors for disability in older persons over 3-year follow-up[J]. Age Ageing, 2010, 39(1): 92-98. DOI: 10.1093/ageing/afp209.
[16]	Buchner DM. Physical activity to prevent or reverse disability in sedentary older adults[J]. Am J Prev Med, 2003, 25(3 Suppl 2): 214-215. DOI: 10.1016/S0749-3797(03)00188-0.
[17]	Chen S, Qin J, Li Y, et al. Disability and Its Influencing Factors among the Elderly in a County, Guangxi Province, China[J]. Int J Environ Res Public Health, 2018, 15(9): 1967. DOI: 10.3390/ijerph15091967.
[18]	梁丹燕, 李虹, 梁耀洁, 等. 南宁市成年吸烟者的尼古丁依赖性及影响因素的研究[J]. 中华疾病控制杂志, 2016, 20(5): 447-451. DOI: 10.16462/j.cnki.zhjbkz.2016.05.005. Liang DY, Li H, Liang YJ, et al. Investigation of nicotine dependence and its influencing factors among adult smokers in Nanning Prefecture[J]. Chin J Dis Control Prev, 2016, 20(5): 447-451. DOI: 10.16462/j.cnki.zhjbkz.2016.05.005.