中国老年人内在能力与日常生活活动的相关性:基于CHARLS数据

Correlation between intrinsic capacity and activities of daily living for old adults in China:based on China Health and Retirement Longitudinal Study

目的探讨老年人内在能力各维度权重和综合指数,检验内在能力与老年人日常生活活动(ADL)受限的相关性。方法采用2015年中国健康与养老追踪(CHARLS)调查中5506例≥60岁老年人的调查数据中关于内在能力和ADL的评估资料。内在能力评估包括认知、运动、活力、感觉和心理,ADL包括穿衣、洗澡、吃饭、上床或下床、如厕以及控制大小便6项。结果共有1343例老年人存在ADL受限(24.4%),其中女性、受教育水平低、年龄大、丧偶、慢性疾病数量多,自评健康较差的老年人,易发生ADL受限。主成分分析显示,心理维度权重最大,其次是认知维度,运动维度权重最低。在控制年龄、性别、居住环境、经济收入、受教育水平、婚姻、吸烟饮酒、慢性疾病数量以及自评健康等混杂因素后,Logistic回归分析显示,运动能力下降(OR=0.581,95%CI 0.501~0.674)、抑郁(OR=0.426,95%CI 0.368~0.493)、视听力受损(OR=0.813,95%CI 0.699~0.947;OR=0.684,95%CI 0.578~0.809)、超重(OR=1.203,95%CI 1.014~1.428)和肥胖(OR=1.584,95%CI 1.312~1.912)是老年人ADL受限的独立危险因素。结论内在能力下降是老年人ADL受限的预测因子。

Objective To explore the weights and comprehensive indices of each field of intrinsic capacity of old adults,and the correlation between intrinsic capacity and activities of daily living(ADL).Methods The data of 5506 cases aged more than 60 years in the 2015 China Health and Retirement Longitudinal Study(CHARLS)were used to collect the assessment of intrinsic capacity and the measurement of ADL.The assessment of intrinsic capacity included cognition,motor,vitality,sensory and psychology;while the ADL scale included six indicators,namely dressing,bathing,eating,getting in or out of bed,going to the toilet,and controlling urine and feces.Results A total of 1343 cases were limited in ADL(24.4%).Women,lower education level,older age,the widowed,greater number of chronic diseases,and poorer self-rated health were the factors more likely to be limited in ADL.Principal component analysis showed that the largest weight value was in psychological domain,followed by the cognitive domain,and the lowest weight value was in the motor domain.After controlling for the effects of age,gender,living environment,economic income,education level,marriage,smoking and drinking,number of chronic diseases,and self-rated health,the Logistic regression analysis showed that low exercise capacity(OR=0.581,95%CI 0.501 to 0.674),depression(OR=0.426,95%CI 0.368 to 0.493),audile and visual impair‐ment(OR=0.813,95%CI 0.699 to 0.947;OR=0.684,95%CI 0.578 to 0.809),overweight(OR=1.203,95%CI 1.014 to 1.428)and obesity(OR=1.584,95%CI 1.312 to 1.912)were independent risk factors for ADL limita‐tion in older adults.Conclusion Decrease of intrinsic capacity is a predictor for ADL limitation in older adults.