湖南省赫山区老年人失能现况及影响因素分析

Current status and influencing factors of disability in the elderly in Heshan District,Hunan Province

目的调查湖南省赫山区65岁以上老年人日常生活活动能力现状及影响因素,为制定干预措施、养老服务规划提供理论依据。方法采用多阶段随机抽样的原则,分别抽取赫山区2个街道(村)共460名65岁以上老年人,对其进行问卷调查。评估基本生活自理能力(basicactivities of daily living,BADL)和工具性日常生活活动能力(instrumental activities of daily living,IADL)。使用χ^(2)检验分析不同特征老年人群失能率差异,采用多因素logistic回归模型分析老年人BADL和IADL失能的影响因素。结果赫山区65岁以上BADL总体失能率为13.76%,IADL总体失能率47.82%。BADL损失率排前3位的项目依次是洗澡、穿衣、上厕所;IADL损失中搭乘公共交通受损率最高(34.06%),其次是使用电话、食物烹调。多因素分析结果显示:年龄越大,BADL、IADL损失的可能性越高;近1年未跌倒(OR=0.429,95%CI:0.182~1.010)、无慢性病(OR=0.136,95%CI:0.056~0.332)是BADL发生的保护因素,而初中以上文化程度(OR=0.418,95%CI:0.217~0.806)、近1年未跌倒(OR=0.313,95%CI:0.137~0.717)、无慢性病(OR=0.250,95%CI:0.141~0.443)是IADL失能的保护因素。结论湖南省益阳市赫山区65岁以上老年人失能率较高。高龄、跌倒、患有慢性病是BADL损失发生的危险因素,高龄、较低的文化程度、跌倒、患慢性病是IADL损失的危险因素,对该地区老年人日常生活活动能力进行有针对性地干预十分必要。

Objective To investigate the status quo of activities of daily living and its influencing factors among the elderly aged above 65 years in Heshan District,Hunan Province,and to provide a theoretical basis for the formulation of intervention measures and service planning for elderly care.Methods Using the principle of multi-stage random sampling,we selected a total of 460 senior citizens aged above 65 years from 2 streets(villages)in Heshan District to conduct a questionnaire survey.Their basic activities of daily living(BADL)and instrumental activities of daily living(IADL)were evaluated.χ^(2) test was used to analyze the difference in the disability rates of the elderly with different characteristics.Multivariate logistic regression model was employed to analyze the factors influencing BADL and IADL disability in the elderly.Results The overall disability rates of BADL and IADL in the elderly aged above 65 years in Heshan District were 13.76%and 47.82%,respectively.The top 3 items in the BADL loss rate were bathing,dressing,and toilet use.As for IADL loss,the loss rate of taking public transportation was the highest(34.06%),followed by telephone use and food cooking.The results of multivariate analysis showed that older age was more likely to have BADL and IADL loss.Having no fall in one recent year(OR=0.429,95%CI:0.182-1.010)and having no chronic diseases(OR=0.136,95%CI:0.056-0.332)were protective factors for the occurrence of BADL,while educational background of junior high school and above(OR=0.418,95%CI:0.217-0.806),having no fall in one recent year(OR=0.313,95%CI:0.137-0.717)and having no chronic diseases(OR=0.250,95%CI:0.141-0.443)were protective factors for IADL disability.Conclusion The disability rate of the elderly aged above 65 years in Heshan District of Yiyang City,Hunan Province was high.Older age,fall and suffering from chronic diseases were risk factors for the occurrence of BADL loss.Older age,less-educated background,fall and suffering from chronic diseases were risk factors for IADL loss.It is necessary to carry out targeted interventions on activities of daily living of the elderly in this district.