高龄老人日常生活活动能力多维度影响因素研究

Study of multi-dimension effect factors of activities of daily life in the oldest old

目的多维度研究高龄老人日常生活活动能力的影响因素。方法选取7个长寿地区的百岁老人，并匹配选取同性别90～99岁、80～89岁高龄老人。通过问卷调查所有老人社会人口学、行为生活方式、功能状态与患病情况、基本日常生活活动（ADL）能力和器具性日常生活活动（IADL）能力调查。测量腰围和血压，测定生化指标。采用多因素logistic回归分析ADL和IADL的影响因素。结果年龄、民族、婚姻状况、居住方式、缺乏身体活动、休闲活动、腹型肥胖、舒张压、甘油三酯水平、认知受损和脑血管疾病是影响ADL的因素，OR（95％CI）值分别为5．10（2．78，9．37）、5．39（2．08，13．91）、0．48（0．25，0．91）、0．25（0．13，0．49）、2．01（1．34，2．98）、0．23（0．15，0．34）、2．34（1．56，3．52）、0．98（0．96，0．99）和0．72（0．54，0．99）、2．16（1．26，3．70）和3．46（1．40，8．52）。影响IADL功能的因素包括年龄、性别、民族、自评经济状况、休闲活动、总胆固醇水平和认知受损，OR（95％CI）值分别为3．08（1．67，5．68）、1．79（1．11，2．89）、1．86（1．12，3．11）、0．46（0．27，0．79）、0．19（0．07，0．55）、1．19（1．02，1．39）和3．11（1．93，5．00）。结论年龄增加、汉族、缺乏身体活动、腹型肥胖、认知受损、脑血管疾病是ADL受损的危险因素，在婚、独居、休闲活动、较高的舒张压和甘油三酯水平是ADL受损的保护因素。年龄增加、汉族、女性、总胆固醇水平和认知受损是IADL功能受损的危险因素，经济状况自评较好和休闲活动是IADL的保护性因素。

Objective To study the effect factors of activities of daily life in the oldest-old in longevity areas. Methods From seven longevity areas, all centenarians were selected and numbered. The old people aged 90-99 and 80-89, according to the age and sex, were appointed by centenarians＇ codes. Information including socioeconomics and demographic charac teristic, behavior lifestyles, function status and prevalence of diseases, basic activities of daily life （ADL）, and instrumental activities of daily life （IADL） were collected. Health examination was checked, and waist circumstance and blood pressure were measured. The levels of triglycerides, total cholesterol, high density lipoprotein cholesterol, fasting plasma glucose were measured, respectively. Multivariate logistic regressions were used to analyze the effect factors of ADL and IADL. Results Multivariate logistic regression showed that age, nationality, marriage status, residing style, lack of physical activity, leisure activities, central obesity, diastolic blood pressure, level of TG, cognition impairment and cerebrovascular disease were effect factors for ADL impairment, with OR （ 95 % CI ） values is 5.10 （2.78, 9.37）, 5.39 （2.08, 13.91）, 0.48 （0.25, 0.91）, 0.25 （0.13, 0.49）, 2.01 （1.34, 2.98）, 0.23 （0.15, 0.34）, 2.34 （1.56, 3.52）, 0.98 （0.96,0.99） , 0.72 （0.54, 0.99）, 2.16 （1.26, 3.70） and3.46 （1.40, 8.52）, respectively. While the effect factors for IADL function were age, sex, nationality, self-evaluation of economics level, leisure activities, total cholesterol and cognitive impairment, with OR （95%CI）was3.08 （1.67, 5.68）, 1.79 （1.11, 2.89）, 1.86 （1.12, 3.11）, 0.46 （0.27, 0.79）, 0.19 （0.07, 0.55）, 1.19 （1.02, 1.39） and3.11 （1.93, 5.00）, respectively. Condusionsincreasing age, Hart nationality, lack of physical activities, central obesity, cognitive impairment and cerebrovascular disease are risk factors of ADL function, while married, residing with oneself, leisure activities, higher level of DBP and, TG are protective factors of ADL. Increasing age, Hart nationality, female, TC and cognitive impairment are risk factors of IADL, while self-evaluation of economics level and leisure activities are protective factors.