老年人身体基本活动能力对失能的影响研究

Correlation between Disability and Basic Movement Ability in Elderly People

背景随着人口老龄化进程的加快,预计到2030年我国≥65岁老年人口占总人口比重将达20%以上,其中失能老年人规模将超过7700万,占总失能人口的比例将≥57%。老年人身体基本活动能力下降可导致其生活质量下降,并使社会及家庭的养老负担加重。目的探究身体基本活动能力对老年人失能状况的影响。方法于2021年3月,采用2015年中国健康与养老全国追踪调查(CHARLS)数据,选取接受了身体基本活动能力、失能状况评估且关键变量值(性别、年龄、户口所在地、受教育程度)完整的老年人5276例作为研究对象。通过握力、站立测试、起坐测试和步速评价老年人的身体基本活动能力,运用工具性日常生活能力(IADL)量表评估老年人失能发生情况。比较不同失能发生情况老年人的握力水平、站立测试与起坐测试完成情况、步速,应用二元Logistic回归探讨身体基本活动能力对老年人失能状况的影响。结果5276例老年人握力为27.92(9.02)kg,其中1713例(32.47%)握力水平为低,1770例(33.55%)握力水平为中等,1793例(33.98%)握力水平为高;3930例(74.49%)能够完成站立测试;5128例(97.19%)能够完成起坐测试;步速为0.96(3.12)m/s,其中1750例(33.17%)步速慢,1759例(33.34%)步速中等,1767例(33.49%)步速快;1419例(26.90%)老年人发生失能。不同失能发生情况老年人握力水平、站立测试与起坐测试完成情况、步速比较,差异有统计学意义(P<0.05)。二元Logistic回归结果显示:无论对于60~74岁还是≥75岁老年人,握力水平、站立测试与起坐测试完成情况、步速均是老年人失能发生的影响因素(P<0.05),特别是无法完成起坐测试的60~74、≥75岁老年人失能的发生风险分别是能够完成者的3.045、4.126倍。结论身体基本活动能力较差的老年人更可能发生失能。建议加强对老年人身体基本活动能力的干预,进而延缓其失能的发生,改善其失能的严重程度,提高其生活质量,最终减少其医疗卫生服务需求的同时,减轻其家庭照护者的照护压力。

Background As the pace of population aging accelerates,the estimated people aged≥65 years will account for more than 20%of the total population in China by 2030,among them those with disability will expand to 77 million,possessing more than 57%of the total disability population.Decline in the basic movement ability can lead to reduced quality of life,and increased burden on society and families.Objective To explore the correlation of basic movement ability with disability status in the elderly.Methods The study was carried out in March 2021.Data were collected from the database of China Health and Retirement Longitudinal Study(CHARLS)in 2015,involving 5276 surveyees aged≥60 years with complete values of assessed basic movement ability and disability and key variables(gender,age,household location,education level).The grip strength test,five-repetition sit-to-stand(FRSTS)test,standing balance test and gait speed test were used to evaluate the basic movement ability.Disability prevalence was evaluated by the Instrumental Activities of Daily Living(IADL)Scale.The grip strength level,gait speed,and prevalence of completion of standing balance test and FRSTS test were compared by the prevalence of disability.Logistic regression was used to analyze the correlation of basic movement ability and disability status.Results The average grip strength value for all individuals was 27.92(9.02)kg.The prevalence of poor,fair and good grip strength was 32.47%(1713/5276),33.55%(1770/5276),and 33.98%(1793/5276),respectively.3930 cases(74.49%)completed the standing balance test.5128 cases(97.19%)completed the FRSTS test.The average gait speed was 0.96(3.12)m/s for all elderly persons.The prevalence of slow,moderate and fast gait speed was 33.17%(1750/5276),33.34%(1759/5276),and 33.49%(1767/5276),respectively.1419 cases(26.90%)were assessed with disabilities.The prevalence of disability varied significantly by grip strength,standing balance and FRSTS test performance,and gait speed(P<0.05).Logistic regression results showed that,poor grip strength,inability to complete the standing balance test and the FRSTS test,and low gait speed were associated with increased risk of disability in both 60-74 years and≥75 years age groups(P<0.05).The inability to complete the FRSTS test was associated with 3.045 times higher risk of disability in the 60-74 age group,and 4.126 times higher risk of disability in the≥75 age group(P<0.05).Conclusion The elderly with poor basic movement ability are prone to disability.In view of this,it is recommended to take measures to improve the basic movement ability of the elderly to delay the onset of disability or relieve the level of disability,thereby improving the quality of life and reducing the health care needs of them,and alleviating the caregiving burden of their family caregivers.