北京市城乡老年人预期寿命和健康预期寿命比较

Regional disparity on life expectancy, active life expectancy in the elderly from Beijing

目的了解北京市老年人预期寿命（LE）、健康预期寿命（ALE）及健康预期寿命比值（ALE／LE）的地区性差异，分析高血压对不同地区老年人生命质量的影响。方法样本来自“北京市老龄化多维纵向研究”，研究对象为北京市城区（宣武区）、农村（大兴区和怀柔区）≥60岁老年人群，2004年基线调查1847人，2007年随访，由调访员入户调查不同地区人群的文化程度、职业及年龄构成，以能否独立完成日常生活活动认定功能健康与否，同时进行高血压病史的调查和现场测量血压，应用多状态寿命表IMaCH软件计算各个年龄段不同地区（城市及农村）的LE、ALE及ALE／LE，分析高血压对于不同地区老年人上述指标的影响。结果研究显示北京市老年人的文化程度、职业构成存在地域差异，农村老年人文化程度低（文盲占66．2％），体力劳动比重高（占95．5％），与城市老年人的差异有统计学意义；农村地区各年龄组LE、ALE均低于城市，ALE／LE农村则高于城市，女性各年龄组城乡差距较男性明显；农村女性各年龄段正常血压组ALE高于城市，而高血压组则低于城市（以60～岁年龄组为例，正常血压农村女性ALE为24．61±2．08，城市女性为20．56±1．92；高血压农村女性ALE为16．34±1．15，城市女性为18．47±3．78），强调了高血压对农村老年女性生命质量的影响。结论北京市老年人的LE、ALE、ALE／LE存在城乡差异，女性城乡差距更大，高血压则增加了城乡差距，降低了农村老年人的生活质量。提示了地域因素对于老年人生活质量的影响，强调了高血压防治的意义。

Objective To explore the regional disparity in life expectancy （LE） , active life expectancy （ALE）, active life expectancy/life expectancy （ALE/LE） of the elderly in Beijing and to express the impact of hypertension upon those indices. Methods The sample was derived from a ＇Beijing multidimensional longitudinal study on aging＇, including those from urban district （Xuanwu） , rural district （Daxing and Huairou） by well-established statistical sampling techniques. Baseline survey comprised 1847 people aged 60 years or over, living in the communities in Beijing in 2004. The subjects under research were investigated with questionnaires at home by well-trained interviews and the contents would include： degree of education, occupation, medical history of hypertension together with repeated blood pressure measurements. Someone being ＇active＇ was defined as the ability in performing activities of daily life （ADL）. IMaCH software for multi-state life table method was used to calculate the life expectancy （LE）, active life expectancy （ALE） and active life expectancy/life expectancy （ALE/LE） in different district and the hypertensive exert influence on those indices. Results Data from the study showed that people inhabited in the rural district had lower LE, ALE and degree of education （illiteracy account for 66.2 percentage） , but with more physical activities （account for 95.5 percentage） and higher ALE/LE than urban district people. Regional disparity in Females was obvious than in males while hypertension would exert more influence on LE of the urban women, which widened the gap in LE, ALE of males and ALE of females between the urban and rural areas. Conclusion Regional disparity was found existing in LE,ALE, ALE/LE of the elderly from Beijing, particularly in females. Hypertension widened the gap and decreased the quality of life on senior citizens in the rural areas. This finding underlined the influence of habitation on the quality of life which manifested the importance of prevention regarding high blood pressure.