中国高龄老年人的生活自理能力变化轨迹及队列差异——基于固定年龄与动态年龄指标的测算

Decline and Cohort Differences in Activities of Daily Living of the Chinese Oldest-old

文章基于中国老年人健康长寿影响因素调查(CLHLS)数据,利用混合效应的多层线性模型对1899~1908、1909~1918和1919~1928年3个出生队列的中国高龄老年人的生活自理能力衰退过程进行了分析,以揭示这一过程中的年龄、队列效应以及内部异质性。分析结果表明,年龄效应和队列效应同时存在于高龄老年人的生活自理能力衰退过程。不同年龄的老年人在死亡前的生活自理能力衰退过程具有趋同性,与日历年龄相比,尚余存活时间与生活自理能力变化之间的关联更为密切。高龄老年人的生活自理能力变化存在显著的队列差异,不同社会经济背景、童年经历、健康行为以及生活环境对高龄老年人的生活自理能力变化轨迹影响显著,也是造成队列差异的重要因素。

Using the data of Chinese Longitudinal Healthy Longevity Survey(CLHLS), this study examines the decline process of Activities of Daily Living(ADL) among the Chinese oldest-old born in 1899-1908, 1909-1918 and 1919-1928 by hierarchical linear model(HLM) with mixed effects. This study aims to analyze the age effect, cohort effect, and internal heterogeneity in the process. Results show that there are both age effects and cohort effects in the process of ADL decline among the oldest-old. Similar patterns of ADL decline have been found among the oldest-old died at different ages. Compared to the chronological age, the remaining survival time before death has stronger predictive power on ADL changes. There are significant cohort differences in ADL changes among the oldest-old. Different socio-economic statuses, health behaviors, childhood experiences and living environments affect ADL change trajectories among the oldest-old, and also contribute to cohort differences.