慢性疾病及生活习惯对老年人日常生活能力的影响

Impact of Chronic Diseases and Life Styles on the Activities of Daily Living of the Elderly

目的探讨慢性疾病和生活习惯对65岁及以上老年人日常生活能力(activities of daily living,ADL)的影响,为预防老年人失能提供决策依据。方法 2016年5月—2017年3月,收集230例≥65岁上海市第一人民医院老年科住院及门诊患者的人口学信息、慢性病史和生活习惯,采用ADL-14项量表评估患者的生活自理能力,分析老年人失能与慢性疾病及生活习惯的相关性。结果年龄、居住状况和婚姻状况与基本日常生活能力(basic activities of daily living,BADL)和工具性日常生活能力(instrumental activities of daily living,IADL)均有相关性(P<0.05)。认知障碍、帕金森病、脑梗死、心力衰竭、跌倒史、慢性阻塞性肺疾病、听力障碍和视力障碍是BADL的危险因素(P<0.05);社会参与、体育锻炼、饲养宠物、写文章和看电视是BADL的保护因素(P<0.05)。认知障碍、帕金森病、脑梗死、冠心病、心房颤动、肾功能不全和听力障碍是IADL的危险因素(P<0.05);社会参与、体育锻炼、摄影、写文章和看电视是IADL的保护因素(P<0.05)。结论高龄、丧偶、住院及独居是老年人失能的危险因素,冠心病、心力衰竭、脑梗死、认知障碍、帕金森病和听力障碍等慢性疾病可增加老年人失能的患病率。体育锻炼及良好的生活方式是ADL的保护因素,能降低老年人失能的风险。

Objective To investigate the impact of chronic diseases and life styles on the activities of daily living（ADL）of the elderly aged 65 so as to provide evidence for the prevention of disability in the elderly. Methods The socio-demographic information, chronic disease history and life styles of 230 elderly inpatient and outpatient aged≥65 in Department of Geriatrics,Shanghai General Hospital from May, 2016 to March, 2017 were collected and the 14 item version of the ADL scale was applied in the assessment of their self-care ability of living; the correlation between disability and chronic diseases and lifestyles was analyzed. Results Age, living condition and marital status were correlated to the basic activities of daily living（B ADL） and instrumental activities of daily living（IADL）（P0.05） while cognitive impairment, Parkinson＇s disease, stroke, heart failure,falls, chronic respiratory diseases, hearing impairment and visual impairment were the risk factors of B ADL（P0.05）： social activity, physical exercise, pet ownership, article writing and TV watching were the protective factors of BADL（P0.05）;cognitive impairment, Parkinson＇s disease, stroke, coronary heart disease, atria fibrillation, renal insufficiency and hearing impairment were the risk factors for IADL（P0.05） while social activity, physical exercise, photography, article writing and TV watching were the protective factors of IADL（P0.05）. Conclusions Advanced age, widowhood, hospitalization and living alone are the risk factors of disability in the elderly; the chronic diseases including coronary heart disease, heart failure, stroke,cognitive impairment, Parkinson＇s disease and hearing impairment can increase the probability of disability in the elderly; physical exercise and good lifestyle are the protective factors of ADL, which can reduce the risk of disability in the elderly.