中国65岁及以上老年人日常生活活动能力与死亡的关系

The relationship between the activities of daily living and death in the elderly aged 65 and over in China

目的探讨老年人日常生活活动能力(activities of daily living,ADL)与中短期死亡之间的关系。方法本研究使用了来自中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey,CLHLS)的数据。分析样本包括37173名CLHLS项目历次调查中的新人群,生存结局来自研究对象2~4年后首次跟踪随访调查结果。失能情况是通过ADL能力量表进行测量。计算ADL总分并进行分组之后,本研究通过多种统计建模策略,探讨不同失能水平对老年人死亡的影响。结果调整人口学、健康行为、膳食摄入特征等混杂因素后,ADL总分人群死亡风险存在着统计学关联(RR=1.09,95%CI:1.08~1.09,P<0.001)。以6分组作对照,得分高于6分组的人群发生死亡的风险增加69%(RR=1.69,95%CI:1.65~1.74,P<0.001)。以正常组作为对照组,低级失能组和高级失能组的人群发生死亡的风险分别增加52%和92%(RR=1.52,95%CI:1.47~1.56,P<0.001;RR=1.92,95%CI:1.86~1.97,P<0.001)。结论基于CLHLS样本发现,失能会增加老年人发生死亡的风险,短期随访、低年龄段的失能老年人发生死亡的风险更大。

Objective To explore the relationship between disability in activities of daily living and death in the elderly.Methods Data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS),which is a nationally representative study.The analysis included 37173 subjects,all of whom were new entrants in the year of the interview.The survival outcome was derived from the first follow-up after 2-4 year.And disability was measured using the scale of Activities of Daily Living(ADL).By calculating and grouping the ADL scores,several statistical models were used to analyze the relationship between disability and death in the elderly.Results After adjusted for confounding factors such as demographics,health behaviors,and dietary intake characteristics,a statistical association was observed between ADL total score and the risk of death in the population(RR=1.09,95%CI:1.08-1.09,P<0.001).Compared scored of 6,death for people with scores>6 increased by 69%(RR=1.69,95%CI:1.65-1.74,P<0.001).Compared normal group,the risk of death in the low-grade disability group and the high-grade disability group increase by 52%and 92%,respectively(RR=1.52,95%CI:1.47-1.56,P<0.001;RR=1.92,95%CI:1.86-1.97,P<0.001).Conclusion In the CLHLS sample,disability increases the risk of death in the elderly,and short-term follow-up and low-age disabled elderly are at greater risk of death.