不同家庭收入水平对老年人成功老龄化的影响研究

Impact of Household Income Levels on Successful Aging of the Elderly

背景成功老龄化有助于缓解衰老进程,但可能会受到家庭收入的影响。目的探讨不同家庭收入水平对老年人成功老龄化的影响,为改善中国老年人健康公平提供基础数据。方法选取2018年中国健康与养老追踪调查(CHARLS)60岁及以上的老年人数据,基于各省的家庭年收入水平将老年人群分为高收入老年人(≤33.33%)、中等收入老年人(33.34%~66.66%)和低收入老年人(≥66.67%);根据ROWE和KAHN模型,测量老年人的成功老龄化水平,运用多因素Logistic回归模型分析不同家庭收入水平对成功老龄化的影响。结果最终纳入研究对象7741人,低收入、中等收入、高收入老年人分别为2192人(28.32%)、2680人(34.62%)、2869人(37.06%)。2018年中国老年人成功老龄化水平为15.55%(1204/7741),低收入老年人成功老龄化水平为10.77%(236/2192),低于中等收入(13.62%,365/2680)和高收入老年人(21.02%,603/2869)(P<0.05)。低收入老年人在无功能损失、认知功能正常、无抑郁、积极参与社会活动方面均比中等收入和高收入老年人差(P<0.05),但不同收入老年人重大慢性病患病率比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,控制社会人口学特征(年龄、性别、民族、学历、居住地区)后,中等和高收入老年人成功老龄化水平分别是低收入老年人的1.226倍(OR=1.226,95%CI=1.028~1.463)和1.721倍(OR=1.721,95%CI=1.300~1.882);继续控制健康状况与行为因素(夜间睡眠时长、意外跌倒情况、近1年住院情况、听力、咀嚼功能)后,高收入老年人成功老龄化水平是低收入老年人的1.559倍(OR=1.559,95%CI=1.028~1.463);同时控制家庭生活环境(洗澡设施、家庭卫生)后,高收入老年人成功老龄化水平是低收入老年人的1.461倍(OR=1.461,95%CI=1.207~1.770)(P<0.05)。结论中国老年人的成功老龄化水平较低,家庭收入水平是老年人成功老龄化的独立影响因素。关注低收入家庭老年人的身心健康和功能改善,提高老年人社会参与是推进健康中国建设和积极应对人口老龄化的重要举措。

Background Successful aging can help to alleviate the aging process,but may be affected by household income.Objective To explore the impact of household income on successful aging and provide fundamental data for improving health equity for the elderly in China.Methods Data from the 2018 China Health and Retirement Longitudinal Study(CHARLS)were used to select participants aged 60 and above.The older adults were categorized into the high-income(≤33.33%),middle-income(33.34%-66.66%),and low-income(≥66.67%)groups based on the annual household income levels within each province.Successful aging was measured based on the Rowe and Kahn models and the multivariate Logistic regression was conducted to identify the effects of different levels of household income on successful aging.Results A total of 7741 subjects were finally included with 2192(28.32%),2680(34.62%)and 2869(37.06%)in the low-income group,middleincome group and high-income group,respectively.The proportion of successful aging was 15.55%(1204/7741)among Chinese older adults in 2018,with 21.02%(603/2869)for high-income group,13.62%(365/2680)for middle-income group,and 10.77%(236/2192)for low-income group(P<0.05).Older adults in the low-income group performed worse than those in the middle-income and high-income groups in daily function loss,cognitive function,no depression,and active social participation(P<0.05).However,there was no statistically significant difference in the prevalence of major chronic diseases among the three groups(P>0.05).The results of multivariate Logistic regression analysis showed that after controlling for demographic characteristics(age,gender,ethnicity,education level,and region of residence),the proportion of successful aging in the middle-income and high-income groups was 1.226 times(OR=1.226,95%CI=1.028-1.463)and 1.721 times(OR=1.721,95%CI=1.450-2.044)as high as those in the low-income group;after controlling for health status and behavioral factors(night sleep duration,accidental falls,hospitalization in the past year,hearing,and masticatory function),the proportion of successful aging in the high-income group was 1.559 times higher than that in the low-income group(OR=1.559,95%CI=1.300-1.882);after controlling for home living environment(bathing facilities,home hygiene),the proportion of successful aging in the high-income group was 1.461 times higher than that in the low-income group(OR=1.461,95%CI=1.207-1.770)(P<0.05).Conclusion The proportion of successful aging in China is low,and the level of household income is an independent influencing factor for successful aging.Focus on the improvement of physical and mental health and function,increasing the social participation of older adults might be important measures to promote the construction of Healthy China and active responding to population aging.