江西部分社区居民衰老度变化及其拐点年龄探索研究

杨善岚; 涂嘉欣; 张朗朗; 吴磊; 黄河浪

doi:10.16462/j.cnki.zhjbkz.2023.12.012

江西部分社区居民衰老度变化及其拐点年龄探索研究

doi: 10.16462/j.cnki.zhjbkz.2023.12.012

南昌大学公共卫生学院流行病与卫生统计学系，江西省预防医学重点实验室，南昌 330006

基金项目:

国家自然科学基金 81960620

国家自然科学基金 81360446

国家自然科学基金 71663037

详细信息

通讯作者:
黄河浪, E-mail: hhlang0821@sina.com

中图分类号: R181
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出版历程
- 收稿日期: 2022-10-25
- 修回日期: 2023-01-28
- 刊出日期: 2023-12-10

An exploratory study on the change of aging degree and inflection point age of residents in some communities in Jiangxi Province

Department of Epidemic and Health Statistics, School of Public Health of Nanchang University, Jiangxi Province Key Laboratory of Preventive Medicine, Nanchang 330006, China

Funds:

National Natural Science Foundation of China 81960620

National Natural Science Foundation of China 81360446

National Natural Science Foundation of China 71663037

More Information

Corresponding author: HUANG Helang, E-mail: hhlang0821@sina.com

摘要

摘要: 目的探索人群衰老变化特点，揭示全生命周期衰老拐点年龄，阐明衰老发展的非匀速过程，为人群主动健康提供针对性干预时段。方法采用多阶段分层整群抽样抽取有效研究对象5 106名，采用生理-心理-社会三维人体衰老度量表(physiological-psychological-social three dimensional human aging scale, PPSHAS)进行衰老度测量，所得衰老度分值经局部加权回归(locally weighted regression, LOESS)平滑曲线拟合；通过受试者工作特征(receiver operator characteristic，ROC)曲线分析衰老拐点年龄，用logistic回归分析模型及其C指数验证其对衰老度的预测价值。结果不同年龄段居民衰老度分值差异均有统计学意义(均P＜0.05)，随年龄波浪式升高。按WHO划分的青年人、中年人、年轻老人、老人的4类人群衰老拐点分析，提示26.0、38.0、47.0、57.1、61.6、68.5、76.9和83.8岁为衰老拐点(均P＜0.05)；混杂因素调整后，拐点年龄对预测衰老度变化仍有价值，模型一致性好(Hosmer-Lemeshow检验P＞0.05)。结论机体衰老变化过程并非匀速，4类人群均会出现衰老拐点；本研究对深入认识衰老、把握衰老规律及针对性做好抗衰老工作有积极意义。
- 衰老度 /
- 拐点年龄 /
- 受试者工作特征曲线 /
- 现场流行病学 /
- 老年人
Abstract: Objective To explore the characteristics of aging changes in the population, reveal the inflection point age in the whole life cycle, clarify the nonlinear process of aging development, and provide targeted intervention periods for the active health of the population. Methods Using multistage stratified cluster sampling, 5 106 valid subjects were selected. The physiological-psychological-social three dimensional human aging scale (PPSHAS) scale was used to measure the degree of aging. Score of the aging degree was fitted by the LOESS smoothing curve; The age of aging inflection point was analyzed by ROC curve, and its predictive value on aging degree was verified by logistic regression model and the C index. Results Significant differences were found in the scores of aging degree among different age groups (all P < 0.05), and it increased in a wave-like manner with age. According to the WHO′s analysis of aging inflection points for four groups (young, middle-aged, older, and elderly), the inflection point ages of aging were found to be 26.0, 38.0, 47.0, 57.1, 61.6, 68.5, 76.9, and 83.8 years, respectively (all P < 0.05). After adjusting for confounding factors, the inflection point age remained a valuable predictor of changes in the aging degree, with good model consistency (Hosmer Lemeshow test P>0.05). Conclusions The aging process of the human body is uniform, and the four groups of people have aging inflection points. This study is of positive significance to deeply understand aging, grasp aging laws, and do a targeted anti-aging work.
- Aging degree /
- Inflection point age /
- Receiver operator characteristic curve /
- Field epidemiology /
- Older adults

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图 1 不同年龄层人群衰老度分值拟合局部加权回归曲线平滑图

Figure 1. Locally weighted regression curve smoothing chart of aging score among different age groups

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表 1 不同年龄层人群衰老标准化分值分布及比较

Table 1. Distribution and comparison of standardized score of aging among different age groups

年龄层 Age groups	年龄组/岁 Age group/year	测量人数 Number of people measured	占比/% Proportion/%	不同维度Different dimensions			总维度 Total dimension
年龄层 Age groups	年龄组/岁 Age group/year	测量人数 Number of people measured	占比/% Proportion/%	生理 Physiological	心理 Psychological	社会 Social	总维度 Total dimension
青年人Young group(20~＜45岁year)	20~＜23	49	5.39	15.68±2.97	12.07±1.45	4.76±1.01	32.51±4.21
	23~＜26	109	12.00	15.39±2.19	11.82±1.47	4.80±0.80	32.01±3.45
	26~＜29	117	12.87	17.32±4.11	12.13±1.44	5.04±0.94	34.49±5.19
	29~＜32	78	8.58	18.18±4.87	12.53±1.82	5.49±1.48	36.20±6.82
	32~＜35	99	10.89	18.24±4.69	12.43±1.98	5.18±1.09	35.86±6.81
	35~＜38	155	17.05	19.10±5.47	12.76±1.84	5.27±1.27	37.12±7.64
	38~＜41	140	15.40	20.91±5.32	13.10±1.90	5.39±1.14	39.40±7.05
	41~＜44	125	13.75	21.30±5.37	12.83±1.95	5.36±1.06	39.49±7.25
	44~＜45	37	4.07	18.74±5.12	12.54±1.82	5.20±1.13	36.47±6.95
	累计Total	909	100.00	18.73±5.12	12.53±1.82	5.20±1.13	36.47±6.95
	F值	— ^②	— ^②	23.779	6.900	5.333	21.070
	P值			＜0.001	＜0.001	＜0.001	＜0.001
中年人Middle-aged group(45~＜60岁year)	45~＜48	273	23.19	23.15±6.24	6.24±2.04	5.45±1.19	41.56±8.26
	48~＜51	223	18.95	24.80±5.57	5.57±2.12	5.36±1.28	42.99±7.70
	51~＜54	257	21.84	25.55±4.83	4.83±2.31	5.60±1.36	44.76±6.95
	54~＜57	258	21.92	27.00±5.21	5.21±2.58	5.62±1.21	46.19±7.74
	57~＜60	166	14.10	27.98±5.18	5.18±2.31	5.60±1.43	47.50±7.25
	累计Total	1 177	100.00	25.51±5.69	13.34±2.31	5.52±1.29	44.38±7.89
	F值	— ^②	— ^②	27.104	9.033	1.906	22.004
	P值			＜0.001	＜0.001	0.107	＜0.001
年轻老人Young elderly group(60~＜75岁year)	60~＜63	394	20.41	28.69±4.82	13.97±2.27	5.72±1.18	48.38±6.70
	63~＜66	446	23.11	29.59±4.68	13.84±2.43	5.62±1.19	49.05±6.75
	66~＜69	412	21.35	30.98±4.52	13.89±2.46	5.72±1.28	50.60±6.70
	69~＜72	360	18.65	32.79±4.47	14.15±2.32	5.81±1.17	52.76±6.51
	72~＜75	318	16.48	34.04±4.79	14.22±2.33	5.99±1.29	54.25±6.68
	累计Total	1 930	100.00	31.03±5.03	14.00±2.37	5.76±1.23	50.79±7.00
	F值	— ^②	— ^②	81.825	1.781	4.769	49.734
	P值			＜0.001	0.130	0.001	＜0.001
老年人Elderly group(≥75岁year)	75~＜78	307	28.17	34.89±4.86	14.71±2.29	6.29±1.53	55.89±7.10
	78~＜81	271	24.86	36.31±4.57	14.83±2.39	6.51±1.56	57.65±6.91
	81~＜84	223	20.46	37.65±4.37	15.13±2.56	6.88±1.85	59.66±7.15
	84~＜87	138	12.66	38.43±4.93	15.48±2.47	7.02±1.58	60.92±7.31
	87~＜90	74	6.79	39.43±3.84	15.86±2.60	7.59±2.07	62.88±6.74
	≥90^①	77	7.06	40.29±5.71	16.42±2.64	8.25±2.22	64.96±8.60
	累计Total	1 090	100.00	36.95±4.99	15.12±2.49	6.78±1.79	58.85±7.65
	F值	— ^②	— ^②	81.825	1.781	4.769	49.734
	P值			＜0.001	0.130	0.001	＜0.001
合计Total		5 106	100.00	28.84±7.97	13.83±2.44	5.82±1.47	48.49±10.42
F值		— ^②	— ^②	2 304.179	232.369	263.356	1 716.716
P值		— ^②	— ^②	＜0.001	＜0.001	＜0.001	＜0.001
注：①该组的实际年龄最大为103岁。②“—”代表无统计量。 Note: ① Indicates the maximum chronological age in this group was 103 years old. ② "—" indicates no statistics.

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表 2 不同年龄层人群衰老度拐点年龄的受试者工作特征曲线分析

Table 2. Receiver operator characteristic curve analysis of aging inflection point age among different age groups

年龄层 Age groups	年龄细分 Age segmentation	测量人数 Number of people measured	AUC(95% CI)	敏感度 Sensitivity	特异度 Specificity	最大约登指数 Youden index	拐点年龄 Inflection point age	P值 value
青年人Young group (20~＜45岁year)	＜P₅₀	354	0.671(0.620~0.720)	0.703	0.596	0.298 4	26.0	0.000 1
	≥P₅₀	555	0.625(0.584~0.666)	0.644	0.557	0.200 8	38.0	0.000 1
中年人Middle-aged group (45~＜60岁year)	＜P₅₀	603	0.616(0.576~0.655)	0.765	0.447	0.211 9	47.0	0.000 1
	≥P₅₀	574	0.564(0.523~0.605)	0.338	0.774	0.111 5	57.1	0.007 0
年轻老人Young elderly group (60~＜75岁year)	＜P₅₀	1 030	0.553(0.522~0.584)	0.781	0.320	0.101 0	61.6	0.002 9
	≥P₅₀	900	0.606(0.573~0.638)	0.811	0.358	0.168 9	68.5	0.000 1
老年人Elderly group (≥75岁year)	＜P₅₀	616	0.591(0.551~0.630)	0.695	0.481	0.175 3	76.9	0.000 1
	≥P₅₀	474	0.635(0.590~0.678)	0.633	0.582	0.215 2	83.8	0.000 1

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表 3 不同年龄层人群衰老度拐点年龄的ROC分析

Table 3. ROC analysis of aging inflection point age among different age groups

年龄层 Age Groups	年龄细分 Age segmentation	β值 value	s_x	Wald	P值 value	OR值 value	95% CI	P₁值 value	C指数 C-index	95% CI
青年人Young Group (20~＜45岁year)	＜P₅₀	0.765	0.268	8.137	0.004	2.149	1.270~3.634	0.340	0.731	0.682~0.777
	≥P₅₀	0.735	0.192	14.700	＜0.001	2.086	1.433~3.038	0.253	0.728	0.689~0.765
中年人Middle-aged group (45~＜60岁year)	＜P₅₀	0.991	0.182	29.598	＜0.001	2.693	1.885~3.848	0.328	0.645	0.606~0.684
	≥P₅₀	0.563	0.194	8.413	0.004	1.756	1.200~2.568	0.837	0.723	0.682~0.763
年轻老人Young elderly group (60~＜75岁year)	＜P₅₀	0.473	0.146	10.542	0.001	1.605	1.206~2.135	0.305	0.727	0.697~0.757
	≥P₅₀	0.854	0.161	27.962	＜0.001	2.349	1.712~3.223	0.255	0.670	0.638~0.700
老年人Elderly group (≥75岁year)	＜P₅₀	0.666	0.175	14.536	＜0.001	1.946	1.382~2.740	0.663	0.764	0.624~0.700
	≥P₅₀	0.895	0.195	21.071	＜0.001	2.446	1.670~3.584	0.340	0.665	0.621~0.708
注：P₁值为Hosmer-Lemeshow检验结果。 Note: P₁ value are the results of Hosmer-Lemeshow test.

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