Prevalence of multiple chronic conditions and its impact on physical functioning among community elderly in a district of Shenzhen city
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摘要:
目的 了解广东省深圳市南山区社区老年人慢性病共病（MCC）患病情况及其对身体功能的影响，为提高老年人的生命质量提供参考依据。 方法 于2018年1月 — 2019年12月采用随机整群抽样方法，抽取在深圳市南山区62个社区健康服务中心健康体检的4475名 ≥ 65岁社区老年人进行问卷调查和身体功能测量，并应用多因素非条件logistic回归模型分析社区老年人MCC患病情况及对其身体功能的影响。 结果 深圳市南山区最终纳入的4297名社区老年人中，患MCC者2728例，患病率为63.49%；在2728例患MCC社区老年人中，患2种慢性病者1043例 （38.23%），患3种慢性病者793例（29.07%），患 ≥ 4种慢性病者892例（32.70%）；4297名社区老年人中，身体功能下降者745人（17.34%），步速下降者1293人（30.09%），起坐时间延长者1475人（34.33%），握力下降者1761人（40.98%）；在调整了性别、年龄、文化程度、婚姻状况、户籍地、吸烟情况和饮酒情况等混杂因素后，多因素非条件logistic回归分析结果显示，深圳市南山区患MCC社区老年人身体功能下降、步速下降和起坐时间延长的风险分别为未患MCC社区老年人的1.52倍（OR = 1.52，95%CI = 1.26 ～1.82）、1.83倍（OR = 1.83，95%CI = 1.45～2.30）和1.22倍（OR = 1.22，95%CI = 1.06～1.39）。 结论 深圳市南山区社区老年人MCC患病率较高，其可增加老年人身体功能、步速下降及起坐时间延长的风险。 -
关键词:
- 慢性病共病（MCC） /
- 身体功能 /
- 影响 /
- 社区老年人
Abstract:Objective To examine the prevalence of multiple chronic conditions (MCC) among community-dwelling elderly in a district of Shenzhen city for providing evidence to life quality promotion of the population. Methods At 62 community health care centers in Nanshan district of Shenzhen city and with random cluster sampling and a self-designed questionnaire, face-to-face interview and physical examination were conducted among 4 475 physical examinees aged 65 years and above from 2018 through 2019 to collect information relevant to MCC prevalence. The physical function of the elderly was assessed using grip strength tests and Short Physical Performance Battery assessments. Unconditional multivariate logistic regression analysis was performed to explore the relationship between MCC and physical function decline. Results Among the 4 297 participants included in the final analysis, 2 728 (63.49%) were identified as having MCC; of the MCC sufferers, 1043 (38.23%), 793 (29.07%), and 892 (32.70%) had two, three, and four and more chronic conditions. Physical function decline was assessed for 745 (17.34%) of all the participants, and the number (percentage) of the participants assessed as having decreased gait speed, prolonged sitting up time, and decreased grip strength were 1 761 (40.98%), 1 475 (35.33%), and 1 761 (40.98%), respectively. After adjusting for sex, age, education, marital status, registered residence, smoking, and alcohol drinking, the results of logistic regression analysis showed that the participants with MCC were at significantly increased risk of reduced physical function (odds ratio [OR] = 1.52, 95% confidence interval [95% CI]:1.26 – 1.82), decreased gait speed (OR = 1.83, 95% CI:1.45 – 2.30), and prolonged sitting up time (OR = 1.22, 95% CI:1.06 – 1.39) compared to those without the conditions. Conclusion The study findings indicate a high prevalence of MCC and the prevalence is associated with increased risks of physical function decline, reduced gait speed, and prolonged sitting up time among the community-dwelling elderly people in Nanshan district of Shenzhen city. -
Key words:
- multiple chronic conditions /
- physical function /
- impact /
- community elderly
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表 1 深圳市南山区不同特征社区老年人MCC患病情况比较
Table 1. Prevalence of MCC by demographics, smoking, alcohol drinking, and declined physical functions among 4 475 community residents age ≥ 65 years in Nanshan district of Shenzhen city
特征 调查人数 MCC患病例数 MCC患病率（%） χ2 值 P 值 性别 男性 1 829 1131 61.84 3.613 0.057 女性 2468 1597 64.71 年龄（岁） 65～75 3186 1 910 59.95 65.889 < 0.001 > 75 1111 818 73.63 文化程度 小学及以下 1280 786 61.41 6.511 0.039 中学/中专 2464 1568 63.64 大专及以上 553 374 67.63 婚姻状况 非在婚 916 604 65.94 2.888 0.089 在婚 3381 2124 62.82 户籍地 城市 2550 1679 65.84 14.782 < 0.001 农村 1747 1049 60.05 吸烟情况 不吸烟 3413 2176 63.76 14.931 < 0.001 已戒烟 503 341 67.79 吸烟 381 211 55.38 饮酒情况 不饮酒 3879 2486 64.09 5.981 0.014 饮酒 418 242 57.89 是否身体功能下降 否 3552 2181 61.40 37.871 < 0.001 是 745 547 73.42 是否步行速度减慢 否 3004 1 983 66.01 27.475 < 0.001 是 1293 745 57.62 是否起坐时间延长 否 2822 1737 61.55 13.024 < 0.001 是 1475 991 67.19 是否握力下降 否 2536 1591 62.74 1.702 0.192 是 1761 1137 64.57 
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