六安城乡社区老年人慢性病与日常生活能力的相关性研究

Associations between chronic diseases and activities of daily living of elderly in Lu’an urban and rural communities

目的了解城乡社区老年人慢性病与日常生活能力(ADL)的现状,并分析两者的相关性。方法采用分层整群抽样,选取六安市城镇和农村两个社区60岁以上老年人进行问卷调查。用慢性病筛查量表调查慢性病患病情况,用Barthel指数评定量表评价ADL。结果该研究共有1080人完成现场调查,去除未完成Barthel指数评定量表者后有983人纳入分析,老年人慢性病的患病率为77.2%(759人),ADL受损检出率31.7%(312人),患有慢性病的老年人ADL受损检出率(29.2%)高于未患慢性病的老年人(17.4%)(P<0.05)。调整社会人口学变量后,多因素Logistic回归显示高血压(OR=1.747,95%CI:1.229~2.484)、冠心病(OR=1.614,95%CI:1.061~2.457)、脑卒中(OR=4.942,95%CI:2.735~8.871)与ADL受损有关联(P<0.05),与不患慢性病的老年人比较,患有1种慢性病(OR=1.851,95%CI:1.201~2.853)、2种慢性病(OR=2.918,95%CI:1.783~4.773)、2种以上慢性病(OR=5.490,95%CI:2.636~11.430)会增加ADL受损的危险性;非参数检验发现高血压、冠心病、脑卒中患者与非患者在大小便控制、如厕、床椅转移、平地行走、上下楼梯几项评分中差异有统计学意义(P<0.05)。结论六安市城乡社区老年人慢性病与ADL受损相关,其中高血压、冠心病、脑卒中会增加ADL受损的风险,患病数量越多能力损失越大,且ADL损失特征不同。

Objective To describe the status of the chronic diseases and activities of daily living of the elderly in urban and rural communities,and to explore the correlation between them.Methods The elderly people(age older than 60)from urban and rural communities in Lu’an were recruited to be investigated and to be taken a physical examination by multistage stratified cluster sampling.The chronic disease screening scale and Barthel index were used to evaluate chronic diseases and activities of daily living,respectively.Results A total of 1080 elderly people completed the survey and 983 people were finally included in the analysis after removing those who did not complete the Barthel index rating scale.In the elderly,the prevalence of chronic diseases was 77.2%(759 cases),and the detection rate of daily living dysfunction was 31.7%(312 cases).Compared with the healthy elderly(17.4%),the rate of daily living dysfunction detection among elderly people with chronic diseases(29.2%)was higher.After adjusting for sociodemographic variables,multivariate logistic regression revealed hypertension(OR=1.747,95%CI:1.229~2.484),coronary heart disease(OR=1.614,95%CI:1.061~2.457),and stroke(OR=4.942,95%CI:2.735~8.871)were associated with impaired daily living ability(P<0.05).Compared with the healthy elderly,the elderly with one chronic diseases(OR=1.851,95%CI:1.201~2.853),two chronic diseases(OR=2.918,95%CI:1.783~4.773),and more than two chronic diseases(OR=5.490,95%CI:2.636~11.430)had a higher detection rate of daily living dysfunction.Nonparametric test found that compared with the healthy elderly,patients with hypertension,coronary heart disease,and stroke had different scores in urinary control,toileting,bed and chair transfer,walking on flat ground,and going up and down stairs(P<0.05).Conclusion Chronic diseases are associated with daily living dysfunction in Lu’an urban and rural communities’elderly people.Hypertension,coronary heart disease,stroke,and chronic comorbidities increase the risk of daily living dysfunction,and these diseases cause different functional impairments.