Effect of local rainfall on frailty among older adults: a generalized linear mixed model analysis on CLHLS data
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摘要:
目的 探究中国老年人虚弱状态与居住地降雨量之间的关联。 方法 以2005 — 2014年中国老年健康影响因素跟踪调查(CLHLS)所获取的数据为基础,对10 424名 ≥ 65岁老年人进行重复测量分析,虚弱状态由虚弱指数(FI)评估,利用广义线性混合模型结合自然立方样条函数探讨居住地降雨量与虚弱状态的关联。 结果 2005年基线时期调查对象平均年龄为(82.84 ± 11.30)岁,虚弱患病率为18.6%(1 936/10 424),在2014年完成4次随访后,虚弱患病率增加至27.8%(709/2 553)。多因素回归分析结果显示,居住在年平均降雨量较高地区的老年人患虚弱的可能性低(OR = 0.60,95%CI = 0.50~0.71),未发现居住地降雨量与老年人虚弱前期状态的发生有关。 结论 居住地降雨量是老年人虚弱的保护因素,可针对不同地区的降雨量为老年人制定适应性策略。 Abstract:Objective To evaluate the relationship between local rainfall and frailty in the elderly. Methods The information on 10 424 elderly aged 65 years and above were extracted from four rounds of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted between 2005 and 2014 across China. Frailty index (FI) was used to assess frail status of the elderly; generalized linear mixed model and natural cubic spline function were adopted to explore the association of local rainfall with the prevalence of frailty. Results The baseline prevalence of frailty was 18.6% for all the elderly aged 82.84 ± 11.30 years at baseline survey; at the last follow-up, the frailty prevalence increased to 27.8%. The results of multivariate regression analysis showed that the elderly living in regions with higher annual average local rainfall (highest quartile) had a lower risk of frailty (odds ratio = 0.60, 95% confidence interval: 0.50 – 0.71) compared to those living in regions with lower local rainfall (lowest quartile); while the correlation of local rainfall with prefrailty of the elderly was not significant. Conclusion Local rainfall has a protective effect on the frailty of the elderly and specific concern should be paid when developing relevant healthcare strategies for the elderly in regions with different amount of rainfall. -
Key words:
- frailty /
- annual average rainfall /
- older people /
- generalized linear mixed model
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表 1 基线受访者基本特征及虚弱情况
基线特征 调查人数 健康 虚弱前期 虚弱 P 值 人数 % 人数 % 人数 % 年龄(岁) 65~79 4 143 2 564 61.89 1 371 33.09 208 5.02 < 0.001 ≥ 80 6 281 1 732 27.58 2 821 44.91 1 728 27.51 性别 女性 5 796 1 896 32.71 2 479 42.77 1 421 24.52 < 0.001 男性 4 628 2 400 51.86 1 714 37.04 514 11.11 民族 汉族 9 760 3 999 40.97 3 939 40.36 1 822 18.67 0.486 少数民族 664 297 44.73 254 38.25 113 17.02 居住地 城镇 4 192 1 701 40.57 1 644 39.22 847 20.21 0.015 农村 6 232 2 595 41.64 2 549 40.90 1 088 17.46 婚姻状况 已婚 4 269 2 383 55.82 1 524 35.70 362 8.48 < 0.001 未婚/丧偶/离异 6 155 1 913 31.08 2 668 43.35 1 574 25.57 受教育程度 文盲 6 019 1 944 32.30 2 601 43.21 1 474 24.49 < 0.001 非文盲 4 405 2 351 53.37 1 592 36.14 462 10.49 60岁前的主要职业 农业 6 727 2 775 41.25 2 731 40.60 1 221 18.15 0.654 非农业 3 697 1 521 41.14 1 462 39.55 714 19.31 去年家庭总收入(元) < 10 000 7 306 3 037 41.57 2 992 40.95 1 277 17.48 0.001 ≥ 10 000 3 118 1 258 40.35 1 201 38.52 659 21.14 是否吸烟 否 8 239 3 091 37.52 3 401 41.28 1 747 21.20 < 0.001 是 2 185 1 205 55.15 791 36.20 189 8.65 是否饮酒 否 8 171 3 116 38.13 3 355 41.06 1 700 20.81 < 0.001 是 2 253 1 179 52.33 838 37.19 236 10.47 是否运动 否 6 966 2 622 37.64 2 728 39.16 1 616 23.20 < 0.001 是 3 458 1 674 48.41 1 465 42.37 319 9.22 地理区域 东部 4 707 1 867 39.66 1 874 39.81 966 20.52 < 0.001 中/西部 5 717 2 428 42.47 2 319 40.56 970 16.97 年平均降雨量(mm) Q1 2 616 1 045 39.95 1 010 38.61 561 21.44 < 0.001 Q2 2 670 1 007 37.72 1 096 41.05 567 21.24 Q3 2 559 1 080 42.20 1 062 41.50 417 16.30 Q4 2 579 1 164 45.13 1 025 39.74 390 15.12 表 2 老年人虚弱状态广义线性混合模型单因素分析
因素 比较组 参照组 虚弱前期 虚弱 OR 值 95%CI P 值 OR 值 95%CI P 值 年龄(岁) ≥ 80 65~79 2.77 2.60~2.94 < 0.001 12.98 11.80~14.27 < 0.001 性别 女性 男性 1.68 1.58~1.79 < 0.001 2.85 2.64~3.08 < 0.001 民族 汉族 少数民族 1.15 1.02~1.30 0.027 1.16 0.99~1.36 0.074 居住地 城镇 农村 1.01 0.95~1.07 0.744 1.32 1.23~1.41 < 0.001 婚姻状况 已婚 未婚/丧偶/离异 0.48 0.46~0.51 < 0.001 0.20 0.18~0.21 < 0.001 受教育程度 文盲 非文盲 1.85 1.75~1.97 < 0.001 3.43 3.17~3.71 < 0.001 60岁前的主要职业 农业 非农业 1.09 1.03~1.17 0.005 0.94 0.86~1.01 0.106 去年家庭总收入(元) ≥ 10 000 < 10 000 1.04 0.98~1.10 0.178 1.63 1.52~1.75 < 0.001 是否吸烟 是 否 0.61 0.57~0.66 < 0.001 0.28 0.25~0.31 < 0.001 是否饮酒 是 否 0.63 0.59~0.68 < 0.001 0.32 0.29~0.35 < 0.001 是否运动 是 否 0.83 0.78~0.89 < 0.001 0.22 0.20~0.24 < 0.001 地理区域 东部 中/西部 1.00 0.94~1.06 0.937 1.11 1.03~1.20 0.006 年平均降雨量(mm) Q2 Q1 1.14 1.05~1.24 0.003 1.05 0.94~1.17 0.364 Q3 1.03 0.95~1.12 0.519 0.73 0.66~0.82 < 0.001 Q4 0.93 0.85~1.01 0.078 0.65 0.59~0.73 < 0.001 表 3 老年人虚弱状态基于广义线性混合模型的多因素分析
因素 比较组 参照组 虚弱前期 虚弱 OR 值 95%CI P 值 OR 值 95%CI P 值 年龄(岁) ≥ 80 65 ~ 79 2.17 2.03~2.32 < 0.001 5.52 4.93~6.17 < 0.001 性别 女性 男性 1.22 1.13~1.31 < 0.001 1.28 1.15~1.42 < 0.001 民族 汉族 少数民族 1.17 1.03~1.34 0.017 1.13 0.94~1.36 0.183 居住地 城镇 农村 1.03 0.96~1.10 0.368 1.36 1.24~1.49 < 0.001 婚姻状况 已婚 未婚/丧偶/离异 0.82 0.76~0.87 < 0.001 0.70 0.63~0.78 < 0.001 受教育程度 文盲 非文盲 1.15 1.07~1.24 < 0.001 1.05 0.94~1.17 0.368 60岁前的主要职业 农业 非农业 0.85 0.79~0.92 < 0.001 0.56 0.51~0.62 < 0.001 去年家庭总收入(元) ≥ 10 000 < 10 000 1.07 1.00~1.14 0.044 1.60 1.47~1.74 < 0.001 是否吸烟 是 否 0.85 0.79~0.93 < 0.001 0.59 0.52~0.67 < 0.001 是否饮酒 是 否 0.79 0.73~0.85 < 0.001 0.58 0.51~0.65 < 0.001 是否运动 是 否 1.04 0.97~1.12 0.269 0.50 0.45~0.55 < 0.001 年平均降雨量(mm) Q2 Q1 1.06 0.95~1.18 0.265 0.85 0.74~0.97 0.019 Q3 1.00 0.89~1.13 0.942 0.66 0.57~0.77 < 0.001 Q4 0.90 0.79~1.03 0.133 0.60 0.50~0.71 < 0.001 -
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