基于多状态Markov模型的我国老年人无失能期望寿命及其影响因素

Determinants of disability free life expectancy in Chinese elderly:based on Multi-states Markov model

目的了解我国老年人无失能期望寿命(DFLE)现状及其影响因素和影响程度。方法利用中国老年人口健康长寿调查研究2011-2018年数据,采用多状态Markov模型和微观仿真法计算我国≥65岁老年人的期望寿命(LE)、DFLE、DFLE占比(DFLE/LE)及危险因素所致的DFLE损失,利用Bootstrap法估计95%CI。结果我国≥65岁老年人DFLE为14.27(95%CI:13.85~14.74)年,女性高于男性,经济状况较好者高于经济状况较差者;DFLE/LE为86.33%(95%CI:85.52%~87.18%),男性高于女性,农村高于城镇。未定期体检、蔬菜水果摄入不足、吸烟和压力分别造成男性0.74、0.41、0.62、0.12年和女性0.82、0.42、0.19、0.20年的DFLE损失。消除以上4种危险因素,可使我国男女性老年人的DFLE分别增长1.73年和1.45年。结论提高我国老年人DFLE应重点关注男性、经济状况较差的人群。促进老年人定期体检和足量的蔬菜水果摄入、禁烟、缓解老年人压力等措施可提高我国老年人的DFLE。

objective To understand and quantify the main influencing factors related to disability free life expectancy(DFLE)among Chinese elderly.Methods Using publicly available data from the Chinese Longitudinal Healthy Longevity Survey(2011-2018),we fitted multi-states Markov model and microsimulation to estimate DFLE at age 65,life expectancy(LE)at age 65 and proportion of DFLE to LE(DFLE/LE)at age 65.We calculated 95%CI by Bootstrap.Result DFLE of the Chinese elderly aged 65 was 14.27(95%CI:13.85-14.74)years,higher in female than male and higher in elderly with higher economic status.DFLE/LE at age 65 was 86.33%(95%CI:85.52%-87.18%),higher in male than female and rural than urban.The risk factors of DFLE include not undergoing physical examination,inadequate fruit/vegetable intake,smoking,and feeling stress,leading to 0.74,0.41,0.62,0.12 years of DFLE lost for male,and 0.82,0.42,0.19,0.20 years of DFLE lost for female,respectively.Eliminating these risk factors can improve DFLE at age 65 by 1.73 years for male and 1.45 years for female.Conclusions Policies targeting male elderly and the elderly with lower economic status,and measures promoting physical examination and adequate fruit/vegetable intake,relieving stress and banning smoking can substantially improve DFLE of Chinese elderly.