体力活动对中国老年人衰弱的影响——基于中国健康与养老追踪调查的实证分析

Effects of Physical Activity on Frailty of Older People in China——An Empirical Analysis Based on CHARLS

目的:分析体力活动对我国老年人衰弱的影响,为预防和干预老年人衰弱的体力活动促进提供科学依据。方法:基于中国健康与养老追踪调查2018年的数据,采用衰弱指数评估中国老年人的衰弱状况,并利用logistic回归模型分析体力活动对衰弱的影响,辅以倾向得分匹配法消除自选择偏差。结果:(1)中国老年人的衰弱患病率为23.59%,衰弱风险随着体力活动能耗的增加而减小,控制其余因素后,体力活动每增加1 MET-h/d,衰弱风险下降4%。(2)相比中高体力活动,低体力活动老年人的衰弱风险是中高体力活动的3.17倍。(3)运用3种倾向得分匹配法修正自选择偏差后,低体力活动对老年人衰弱影响的净效应为20%。(4)异质性分析发现,低体力活动更会增加女性、教育程度低、无配偶、居住在城市老年人的衰弱风险。结论:中国老年人的衰弱患病率高,低体力活动老年人的衰弱风险更高,中高体力活动更有助于降低老年人的衰弱风险,同时二者关系也存在群体异质性。建议社会要重视老年人衰弱问题,开展衰弱筛查,同时积极引导老年人进行体力活动。

Objective:To analyze the effects of physical activity on the frailty of older people in China,and provide scientific basis for preventing and intervening the frailty of physical activity.Methods:Frailty Index(FI)was used to evaluate the frailty of older people in China based on the data of China Health and Retirement Longitudinal Study(CHARLS)in 2018,the logistic regression model was used to analyze the effects of physical activity on frailty,and the propensity score matching was used to eliminate self-selection bias.Results:(1)The prevalence of frailty among older people in China was 23.59%.and the risk of frailty decreases with increasing physical activity energy consumption.When the other factors were controlled,the risk of frailty decreased by 4%for each 1 met-h/d increase in physical activity.(2)Compared with moderate to intensive physical activity,the risk of frailty in older people with low physical activity was 3.17 times higher than that with moderate to intensive physical activity.(3)The net effect of low physical activity on frailty in older people was 20%when the three propensity score matching was used to correct the selection bias of the samples.(4)Heterogeneity analysis showed that low physical activity was more likely to increase the frailty risk of female older people,older people with low education level,older people without spouse,and urban older people.Conclusion:The prevalence of frailty is high among older people in China.The risk of frailty is higher in older people with low physical activity,and moderate to vigor physical activity is more likely to reduce the risk of frailty in older people.Meanwhile,the relationship between physical activity and risk of frailty has also showed group heterogeneity.Society should pay attention to the problem of frailty in older people,carry out frailty screening,and actively guide older people to do physical activity.