呼吸系统疾病对老年人死亡风险影响的前瞻性队列研究

A prospective cohort study on the effect of respiratory diseases on the mortality risk of the Chinese elderly

目的探讨呼吸系统疾病对我国老年人死亡风险的影响。方法以2008年中国老年健康影响因素跟踪调查(CLHLS)访问的12946名老年人作为研究对象,随访该队列老年人至2018年,通过构建Cox比例风险模型分析呼吸系统疾病对老年人死亡风险的影响,并且分为不同性别组和年龄组进行异质性分析。结果相比未患呼吸系统疾病的老年人,患呼吸系统疾病显著增加老年人的死亡风险。具体而言,在全体老年人中,校正混杂因素后,患呼吸系统疾病使其死亡风险增加22%(HR=1.22,95%CI:1.14~1.30),自评呼吸系统疾病对生活有一点影响和有很大影响分别使老年人的死亡风险增加18%(HR=1.18,95%CI:1.09~1.29)和31%(HR=1.31,95%CI:1.18~1.46)。异质性分析表明,呼吸系统疾病使老年男性和老年女性的死亡风险分别增加32%(HR=1.32,95%CI:1.21~1.45)和11%(HR=1.11,95%CI:1.01~1.23);使65~79岁组和80~94岁组老年人的死亡风险分别增加49%(HR=1.49,95%CI:1.26~1.76)和21%(HR=1.21,95%CI:1.11~1.33),但对95~104岁组老年人的死亡风险影响不具备统计学意义(HR=1.09,95%CI:0.97~1.23)。结论呼吸系统疾病是加速老年人死亡的重要危险因素,且呼吸系统疾病对老年男性死亡风险的影响比对老年女性更大,对低龄老年人死亡风险的影响比对高龄老年人更大。

Objective To explore the effect of respiratory diseases on the mortality risk of the elderly in China.Methods Totally 12946 elderly people interviewed by The Chinese Longitudinal Healthy Longevity Survey(CLHLS)in2008 were taken as the research objects.The elderly in this cohort were followed up until 2018.The effect of respiratory diseases on the risk of mortality in the elderly was analyzed by constructing Cox proportional risk model,and heterogeneity was analyzed by gender and age groups.Results Compared with the elderly without respiratory diseases,respiratory diseases significantly increased the risk of mortality in the elderly.Specifically,after adjusting for confounding factors,respiratory diseases increased the overall mortality risk of the elderly by 22%(HR=1.22,95%CI:1.14-1.30),and self-rated respiratory diseases with little or great impact on their own life increased the mortality risk of the elderly by 18%(HR=1.18,95%CI:1.09-1.29)and 31%(HR=1.31,95%CI:1.18-1.46),respectively.Heterogeneity analysis showed that respiratory diseases increased the risk of mortality in male and female elderly by 32%(HR=1.32,95%CI:1.21-1.45)and 11%(HR=1.11,95%CI:1.01-1.23),respectively.Respiratory diseases increased the risk of mortality in the groups aged 65-79 years and 80-94 years by 49%(HR=1.49,95%CI:1.26-1.76)and 21%(HR=1.21,95%CI:1.26-1.76),respectively.However,they did not significantly affect the risk of mortality in the group aged 95-104 years(HR=1.09,95%CI:0.97-1.23).Conclusion Respiratory disease is an important risk factor that accelerates the mortality of the elderly,and the impact of respiratory diseases on the mortality risk of the male elderly is greater than that of the female counterparts,and the impact on the mortality risk of the young elderly is greater than that of the elderly.