中国老年人生活自理能力发展轨迹研究

A Study on Developmental Trajectories of Activities of Daily Living for the Elderly in China

生活自理能力是影响老年人健康及生活质量的最为普遍性的问题。本文利用"中国城乡老年人口状况追踪调查"十年追踪数据对老年人的生活自理能力(ADL和IADL)的发展轨迹进行深入研究。研究发现老年人的ADL自理能力发展轨迹呈现出低起点快速下降型、高起点急速下降型、高起点平稳下降型三种类型,老年人的IADL自理能力发展轨迹则分为低起点快速下降型和高起点缓慢下降型两种类型。不同社会经济特征老年群体在生活自理能力发展轨迹类型上存在显著差异,老年妇女、少数民族老年人、低教育程度者、老年农民和城市从未正式工作过的老年人的生活自理能力发展轨迹属于较差模式的可能性更高。老年人生活自理能力发展轨迹形态受人口社会学特征、健康状况、社会交往、家庭支持等多方面的影响。基于实证研究结果,文章认为应加强社会政策的公平性导向,积极扩展社会经济地位对健康的正向作用;广泛调动家庭和社会力量的介入,通过增加老年人与家人、邻里和朋友的联络、交流和支持来改善健康状况;同时应基于老年人生活自理能力动态发展的模式和特点,构建适合的社会预防照护和长期照护服务体系。

The capability in activities of daily living is the most common problem that affects the health and life quality of the elderly. Based on the ten-year follow-up data from the Sample Survey of the Aged Population in Urban/Rural China,this paper conducted an in-depth study on the developmental trajectories of the activities of daily living of the elderly. It was found that the developmental trajectories of ADL presented three types：rapid decline from low starting point,sharp decline from high starting point,and steady declinefrom high starting point,and that the developmental trajectories of IADL was divided into two types：rapiddecline from low starting point,and slow decline from high starting point. There were significant differencesin types of developmental trajectories of ADL and IADL of the elderly with different social and economiccharacteristics. Among the elderly group including aged women,elders of minority groups,people of low educational level,aged farmers and senior citizens with no formal jobs,their capabilities in activities of dailyliving are more likely to develop in disparate models. The shape of the developmental trajectories was influ-enced by the sociological characteristics,health status,social interaction and family support etc. Based onresults of the empirical study,the author of this article believes that we should strengthen the fairness orien-tation of social policies to expand the positive effect of social and economic status to health,and mobilizethe family and social forces to improve the health of elder group by increasing the communications and supports between the senior citizens and their family members,neighbors and friends. At the same time,we should construct the suitable social care service system based on patterns and characteristics of the dynamic developmental of activities of daily living for the elderly.