基于群组轨迹模型的健康老龄化指数变化轨迹分类及影响因素分析

Trajectories of healthy aging and its influencing factors:a group-based trajectory model

目的探讨我国老年人健康老龄化指数(HAI)的变化轨迹及其影响因素。方法采用中国健康与养老追踪调查平台的4次纵向调查数据,选择内在能力和功能发挥的37个指标,根据双因子模型确定各指标权重,构建HAI。通过基于群组轨迹模型对HAI的变化轨迹进行分组拟合,采用多分类logistic回归分析HAI变化轨迹的影响因素。结果共纳入6327例研究对象,年龄60~96岁,平均(68.0±6.6)岁。根据HAI的变化轨迹,将研究对象分为低水平升高组(4.92%)、中低水平下降组(13.07%)、中水平下降组(30.58%)以及高水平下降组(51.43%)。多分类logistics回归分析显示,与高水平下降组比较,女性(OR=2.410,95%CI:1.753~3.315)、年龄≥70岁(OR=6.377,95%CI:4.666~8.715)、慢性疾病数≥2(OR=6.436,95%CI:4.386~9.442)以及生活水平差(OR=3.007,95%CI:1.512~5.982)的研究对象HAI为低水平升高组的可能性较大,而饮酒(OR=0.555,95%CI:0.380~0.809)和文化程度初中及以上者(OR=0.222,95%CI:0.143~0.344)HAI为低水平升高组的可能性较小。结论性别、年龄、文化程度、慢性疾病数及生活水平可能影响我国老年人HAI的变化轨迹。

Objective To explore the trajectories of healthy aging index(HAI) and its influencing factors.Methods The HAI was constructed by selecting 37 indicators of intrinsic ability and function based on the data from four longitudinal surveys of China Health and Pension Tracking Survey Platform.The weights of each indicator were determined according to the two-factor model.The HAI change trajectories were grouped and fitted by the crowd-based trajectory model,and the influencing factors of HAI change trajectories were analyzed by multi-classification logistic regression.Results A total of 6 327 subjects were included in the study,whoes age from 60 to 96 years old,with average of(68.0±6.6) years old.Four trajectories of HAI were identified,which were low-increase group(4.92%),medium low-decline group(13.07%),medium-decline group(30.58%) and high-decline group(51.43%).The results of multi-classification logistic regression analysis showed that compared with the high-decline group,those who were female(OR=2.410,95%CI:1.753-3.315),age≥70 years old(OR=6.377,95%CI:4.666-8.715),and with more than two chronic diseases(OR=6.436,95%CI:4.386-9.442) and poor living standard(OR=3.007,95%CI:1.512-5.982) had higher odds being low-increase group,while drinkers(OR=0.555,95%CI:0.380-0.809) and those with junior high school(OR=0.222,95%CI:0.143-0.344) had lower odds being low-increase group.Conclusion Gender,age,education level,number of chronic diseases and living standard may affect the trajectory of HAI in the elderly in China.