慢性病对中国中老年人日常生活活动能力受限影响

戴玲燕; 马金香; 陶涛

doi:10.11847/zgggws1117286

慢性病对中国中老年人日常生活活动能力受限影响

Impacts of chronic diseases on limited basic activities of daily living in middle-aged and elderly people in China

摘要

摘要:
目的了解慢性病对中国中老年人日常生活活动能力受限的影响，为提高中老年人的生命质量提供参考依据。
方法收集2011年中国健康与养老基线调查及2013年全国追踪调查中5 296名中老年人慢性病患病及日常生活活动能力受限情况相关数据，应用Cox比例风险回归模型分析慢性病对中老年人日常生活活动能力受限的影响。
结果 5 296名中国中老年人中，未患有慢性病者1 280例（24.17 %），患1种慢性病者1 584例（29.91 %），患2种慢性病者1 222例（23.07 %），患 ≥ 3种慢性病者1 210例（22.85 %）。随访时有1 172例中老年人的日常生活活动能力从自理转变为受限，日常生活活动能力受限发病率为22.13 %；其中，轻、中、重度功能受限分别为921、192、59例，分别占新发受限中老年人的78.58 %、16.38 %、5.04 %；未患慢性病、患1种慢性病、患2种慢性病和患 ≥ 3种慢性病中老年人日常生活活动能力受限发病率分别为15.86 %、21.53 %、23.98 %和29.34 %，随着慢性病患病数量的增多，中老年人日常生活活动能力受限发病率呈上升趋势（χ²_趋势 = 51.949，P < 0.001）；Cox比例风险回归分析结果显示，在控制了性别、年龄、文化程度、婚姻状况、自评经济状况等混杂因素后，与中老年人日常生活活动能力受限相关的慢性病为高血压、脑卒中、肾脏疾病、胃部疾病或消化系统疾病和关节炎/风湿病（均P < 0.05）；在控制了性别、年龄、文化程度、婚姻状况、自评经济状况及其他慢性病患病等混杂因素后，与中老年人日常生活活动能力受限相关的慢性病为高血压、肾脏疾病和关节炎/风湿病（均P < 0.05）。
结论慢性病的数量和种类均与中老年人日常生活活动能力受限相关，重点加强高血压、肾脏疾病和关节炎/风湿病等特定慢性病的管理，将有助于降低中老年人日常生活活动能力受限的发生风险。

Abstract:
Objective To explore the influence of chronic diseases on the limitation of basic activities of daily living (BADL) among middle-aged and elderly people in China and to provide references for enhancing the quality of life in the population.
Methods We extracted data of 5 296 middle-aged and elderly persons on status of chronic diseases and the limitation of BADL from the two datasets of China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011 and 2013. We adopted Cox proportional hazard regression model to evaluate impacts of chronic diseases on the limitation of BADL among the participants.
Results Of the participants, 1 584 (29.91%), 1 222 (23.07%), and 1 210(22.85%) were identified being suffering from one, two, and at least three types of chronic disease and 1 280 (24.17%) were free from any chronic disease. At the second wave of CHARLS, 1 172 (22.13%) participants reported the transition from having no limitation in their BADL to having the limitation within the two years from the first wave of CHARLS. Among the participants reporting the limitation, 921 (78.58%), 192 (16.38%), and 59 (5.04%) reported mild, moderate, and severe limitation and the reported proportion of limitation in BADL rose up significantly with the increment of age (χ²_trend = 51.949, P < 0.001), with the limitation proportions of 15.86%, 21.53%, 23.98%, and 29.34% for the participants with no, one, two, and at least three of chronic diseases, respectively. The results of Cox proportional hazard regression analysis revealed that after adjusting for confounding factors such as gender, age, marital status, education and economic situation, chronic diseases associated with BADL limitation were hypertension, stroke, kidney disease, stomach or other digestive disease, and arthritis/ rheumatism (all P < 0.05); while, after adjusting for gender, age, marital status, education, economic situation, and other chronic diseases, only hypertension, kidney disease, and arthritis/ rheumatism were associated with BADL limitation (all P < 0.05).
Conclusion Both the number and type of chronic diseases are associated with basic activities of daily living limitation and promoting the management on specific chronic diseases such as hypertension, kidney disease, and arthritis/ rheumatism will help reduce the risk of basic activities of daily living limitation among middle-aged and elderly population in China.

HTML全文

参考文献(18)

施引文献

资源附件(0)