|Incidence of activities of daily living disability and related factors in community-dwelling older adults in China
|中文关键词: 老年人 日常生活活动能力 队列研究
|英文关键词: Elderly Activities of daily living Cohort study
| 目的 了解中国城乡社区老年人群2年内日常生活活动能力（ADL）下降情况及其影响因素。方法 调查对象来自老年期重点疾病预防和干预项目。该调查采用多阶段分层整群随机抽样的方法，于2015年从我国6个省份抽取23 803名研究对象进行基线调查，2017年进行随访，剔除死亡、失访、数据不完整和2015年基线调查ADL受损的研究对象后，共计18 785名≥ 60岁的老年人符合纳入标准。以第6次全国人口普查数据为标准人口对样本数据进行加权后，分析不同特征老年人群2年内ADL、基础性日常生活活动能力（BADL）和工具性日常生活活动能力（IADL）受损发生率，并采用多因素logistic回归模型分析相关影响因素。结果 经过2年的随访，队列人群中共有1 959例发生ADL受损，ADL受损的2年累计发生率为12.0%，其中，BADL受损的2年累计发生率为1.6%，仅IADL受损的2年累计发生率为10.4%。多因素logistic回归模型分析结果显示，增加仅BADL受损发生风险的因素是年龄增加、肥胖、≥ 2种共病以及认知功能异常；增加仅IADL受损发生风险的因素为年龄增加、女性、低体重和认知功能异常。降低仅IADL受损发生风险的因素包括小学或初中及以上文化程度、超重或肥胖。结论 年龄增加、认知功能异常均增加BADL和IADL受损发生的风险。患有≥ 2种疾病的老年人BADL受损风险较高；肥胖增加老年人BADL受损发生风险，但降低IADL受损发生风险；女性比男性发生IADL受损风险高；高文化程度的老年人IADL受损风险低。
| Objective To analyze the decline of activities of daily living (ADL) ability and influencing factors over a period of 2 years in community-dwelling older adults in China. Methods The study subjects were from the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China of 2015-2017 to select the samples. In 2015, a total of 23 803 community-dwelling residents adults, aged ≥ 60 years old, came from both urban and rural areas, were selected through a stratified multi-stage cluster sampling in 6 provinces and joint baseline survey. The follow-up was conducted in 2017 to collect the related information using the same questionnaires and examinations. Finally, 18 785 elderly people were included in this analysis after excluding those who were died, failed to follow up, had incomplete data cases or defined as ADL disability at baseline survey. The post-stratification weight on the sample data was done by using the 6th national population census data as the standard, the rates of ADL/basic activities of daily living (BADL)/instrumental activities of daily living (IADL) disabilities over 2 years were calculated and compared among the elderly with different characteristics. Multiple logistic regression models were used to analyze the factors associated with BADL/IADL disabilities. Results During the 2-year follow-up, ADL disability developed in 1 959 participants with a rate of 12.0% (1.6% for BADL disability and 10.4% for IADL disability only). Multivariate logistic regression analysis showed that the risk factors for BADL disability included increased age, obesity, comorbidity and cognitive impairment. The risk factors for only IADL disability included increased age, being female, lower weight and cognitive impairment. Compared with illiterates, the educated had lower risk for only IADL disability. Compared with those with normal weight, overweight and obese old people had lower risk for only IADL disabilities. Conclusion Increased age and cognitive impairment were associated with the increased risk for BADL and IADL disabilities. Older people with comorbidities had higher risk for BADL disability. Obesity increased the risk of BADL disability, but decreased the risk for IADL disability in older people. Women had a higher risk for IADL disability compared with men. Being educated was associated with lower risk of IADL disability.