慢性病对中国65岁及以上老年人日常活动能力影响的队列研究

李正禹; 武继磊; 李佳佳; 裴丽君

Abstract

李正禹,武继磊,李佳佳,裴丽君.慢性病对中国65岁及以上老年人日常活动能力影响的队列研究[J].Chinese journal of Epidemiology,2019,40(1):33-40

慢性病对中国65岁及以上老年人日常活动能力影响的队列研究

A cohort study on the influence of the chronic diseases on activities of daily living of the elderly aged 65 years and over in China

Received:July 04, 2018

DOI：10.3760/cma.j.issn.0254-6450.2019.01.008

KeyWord: 慢性疾病日常活动能力队列研究老年人

English Key Word: Chronic and non-communicable disease Activities of daily living Cohort study Elderly population

FundProject:国家自然科学基金（41871360）；2015年达能营养中心膳食营养研究与宣教基金（DIC2015-05）

Author Name	Affiliation	E-mail
Li Zhengyu	Institute of Population Research, Peking University, Beijing 100871, China
Wu Jilei	Institute of Population Research, Peking University, Beijing 100871, China
Li Jiajia	Institute of Population Research, Peking University, Beijing 100871, China
Pei Lijun	Institute of Population Research, Peking University, Beijing 100871, China	peilj@pku.edu.cn

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Abstract:

目的探讨5类高发慢性病及慢性病患病数目对老年人日常活动能力（ADL）的影响。方法将2002年中国老年健康影响因素跟踪调查访问的10 501名老年人的调查信息作为基线数据，随访该队列人群至2014年，采用Cox比例风险模型分析5类高发慢性病及慢性病患病数目对不同年龄组老年人ADL的影响。结果与不患任何慢性疾病的老年人比较，患高血压可增加各个年龄组老年人的ADL受损风险，65~74岁组增加43%（HR=1.43，95% CI：1.14~1.79），75~89岁组增加21%（HR=1.21，95% CI：1.02~1.43），90~105岁组增加20%（HR=1.20，95% CI：1.02~1.43）；患糖尿病使65~74岁组老年人ADL受损风险增加102%（HR=2.02，95% CI：1.29~3.17），患脑血管病使ADL受损风险增加79%（HR=1.79，95% CI：1.24~2.58）；在整个老年群体中，患1种慢性病使ADL受损风险增加13%（HR=1.13，95% CI：1.02~1.25），患≥ 2种慢性病使ADL受损风险增加25%（HR=1.25，95% CI：1.13~1.40）；患≥ 2种慢性病使65~74、75~89岁老年人ADL受损风险分别增加50%（HR=1.50，95% CI：1.21~1.87）、17%（HR=1.17，95% CI：1.01~1.38）。结论高血压是导致老年人ADL受损的重要危险因素；65~74岁组老年人患高血压、糖尿病、脑血管病或多种慢性病共患均可增加其ADL受损风险。

English Abstract:

Objective To understand the influence of chronic diseases on the risk of impaired activities of daily living (ADL) of the elderly. Methods Baseline data of 10 501 elderly individuals recruited by the Chinese Longitudinal Healthy Longevity Survey in 2002 were used, and follow up for this population was conducted until 2014. Cox Proportional Hazard Model was used to estimate the hazards ratios (HR) for the associations between five kinds of chronic diseases, the number of chronic diseases and the risk of ADL impairment in different age groups of the elderly. Results Hypertension increased the risk of ADL impairment in the elderly of all age groups, which increased the ADL impaired risk by 43% (HR=1.43, 95% CI:1.14-1.79) in group aged 65-74 years, 21% (HR=1.21, 95% CI:1.02-1.43) in group aged 75-89 years and 20% (HR=1.20, 95% CI:1.02-1.43) in group aged 90-105 years, respectively. Diabetes and cerebrovascular disease increased the ADL impaired risk by 102%(HR=2.02, 95% CI:1.29-3.17), and 79% (HR=1.79, 95% CI:1.24-2.58) in group aged 65-74 years, respectively. ‘Suffering from one chronic disease’ increased the ADL impaired risk by 13% (HR=1.13, 95% CI:1.02-1.25), and suffering from two or more chronic diseases increased the ADL impaired risk by 25% (HR=1.25, 95% CI:1.13-1.40) in all the age groups. Suffering from two or more chronic diseases increased the ADL impaired risk by 50% (HR=1.50, 95% CI:1.21-1.87) in group aged 65-74 years and 17% (HR=1.17, 95% CI:1.01-1.38) in groups aged 75-89 years. Conclusions Hypertension was one of the most important risk factors for the impaired ADL in the elderly population in all age groups. Hypertension, diabetes, cerebrovascular disease or comorbidity increased the risk of impaired ADL in group aged 65-74 years.

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