北京市老年人健康预期寿命及其变化

Study on the active life expectancy of the elderly and its longitudinal transition in Beijing

目的 了解北京地区老年人的健康预期寿命和变化。方法 采用纵向研究方法对北京城区(宣武区)、郊区(大兴区)和山区(怀柔县)一个有代表性老年人群(3257人)进行了12年追踪，调查其健康和存活状况。用WHO的基本生活能力评估量表(ADL)，评估老年人躯体功能健康状况及变化，采用IMaCH多状态法分析多次调查结果及不同健康状况的转变，计算老年人的健康预期寿命及不同时段的变化。结果 纵向结果显示一些基本特征在不同时段维持不变：老年人的平均预期寿命(LE)、健康预期寿命(ALE)和健康预期寿命比值(ALE／LE)在城区显著高于农村；女性平均预期寿命高于男性，但ALE／LE低于男性。纵向观察的变化表现为：老年人的平均预期寿命有所提高，增加的幅度在农村大于城区，男性大于女性；城区高龄女性老年人的健康预期寿命近年有明显下降；所有老年人的ALE／LE近年呈下降趋势，尤其是城区老年人和高龄老年人更突出。结论 北京地区老年人的健康预期寿命未与预期寿命同步增长，加强心脑血管疾病等慢性病防治，预防残疾和加强功能康复，是提高老年人健康预期寿命和生活质量的基础。

Objective Focus on the Active Life Expectancy（ALE） of elderly in Beijing and the transition in recent years. Methods A representative sample of 3257 elderly people who lived in the urban, suburban and rural communities in Beijing that had been followed up for 12 years. Their health and survival status had been surveyed every 2-3 years. Activity Daily Living scale（ADL）, recommended by WHO was used to evaluate the physical function capability of the elderly. IMaCH 0.8 was used to estimate life expectancy（LE） and active life expectancy（ALE） for both periods while age,sex and rural/urban residence areas were adjusted. Results Longitudinally, data showed that the main characters remained unchange throughout the two periods including 1 ） LE, ALE, ALE/LE of elderly living in urban area were higher than those living in rural area; 2） LE seemed longer in women than men,but ALE/LE was less in women. The transition between two period showed that 1）LE increased modestly in all groups but less prominent in urban residents and in females; 2） ALE was not significandy changed in the rural elderly but declined markedly in women living in the urban area; 3） ALE/LE of the elderly declined in all groups, especially in urban and oldest old groups. Conclusion In Beijing, elderly ALE did not increase in parallel with the increase of LE while ALE/LE of the elderly declined significandy in recent years. In order to improve quality of life of the elderly and to increase their ALE, emphasis should be given to prevention of cardiovascular, cerebrovascular and other chronic diseases while reducing the occurrence of physical disability and strengthening on rehabilitation would be the basic heahh care measures.