城市社区健康状态较差老年人的状况评估及分析

Assessment and analysis on poor health seniors in Beijing urban communities

目的了解社区健康状态较差的老年人的需求，为合理干预提供依据。方法2013年2月至2013年5月对北京市部分社区≥65（79．2±8．3）岁、健康状态较差的209位老年人进行老年综合评估。结果巴氏日常生活活动能力（Barthel—ADL）正常者50例（23．9％），功能受损者159例（76．1％）；所有老年人均有〉12个多种慢性状况（MCC），受调查者有老年综合征3．9[4（3，5）]个，高于平均慢性疾病数3．5[3（2，4）]个，功能受损组老人慢性疾病及老年综合征数均高于功能正常组（P=0．007，P=0．05）。需要他人照顾者占79．9％，其中照顾者为配偶者占50．3％。每年规律接种流感疫苗者仅占8．1％，规律体检者占14．8％。结论老年综合征对该人群影响更大，应予以重视；社区针对失能老年人的医学照护模式、照顾者负担等问题仍需关注。

Objective To investigate the demands of the seniors in poor health who lived in the urban community in order to provide reference for rational interventions. Methods During February to May 2013, a total of 209 residents of 65 years or older （ mean 79.2 ± 8.3 years old） in poor health conditions living in Beijing urban communities were included in this study, and investigated through comprehensive geriatric assessment （CGA）. Results There were 50 subjects （23.9%） having normal activities of daily living （Barthel ADL） score, and 159（76. 1% ） with impaired ADL score. All the subjects had 2 or more multiple chronic conditions （MCC）. The number of geriatric syndromes （GS） was 3.9[4 （3,5） ], larger than that of chronic diseases { CD, 3.5[3（2,4） ] }. The seniors with impaired ADL had higher numbers of CD and GS than the normal ADL group （ P = 0.007, P = 0.05 ）. One hundred and sixty-seven subjects （79.9%） were dependent on living, among which, 84 caregivers （50. 3% ） were the spouses. Only 8.1% of the subjects got annually influenza vaccination and 14.8% had yearly physical examination. Conclusion GS exerts more effects on the seniors in poor health, so special attention should be paid on the population by health care workers. Reforms should be taken on caregiver burden, health care modes for disabled elderly, and other issues.