老年人自评健康状况与死亡风险的关联分析

Association between self-rated health status and mortality risk among the elderly

目的 了解老年人自评健康状况与死亡风险的关联以及对死亡风险的预测价值。方法 基于中国健康与养老追踪调查(CHARLS)数据库,收集2011—2018年≥60岁人群的社会人口学信息、自评健康状况和死亡情况等资料,采用多因素Cox比例风险回归模型分析老年人自评健康状况与死亡风险的关联。结果 纳入4 850人资料,年龄M (QR)为65 (8)岁。男性2 485人,占51.24%;女性2 365人,占48.76%。自评健康状况为好877人,占18.08%;一般2 078人,占42.85%;不好1 895人,占39.07%。共随访28 955人年,平均每人随访5.97年,至2018年随访结束,死亡855人,生存时间M (QR)为7 (3)年。多因素Cox比例风险回归分析结果显示,年龄、性别与自评健康状况对死亡的影响分别存在交互作用(均P<0.05)。按性别分层结果显示,老年女性中自评健康状况与死亡风险无显著关联(P>0.05);自评健康状况为不好的老年男性死亡风险高于自评健康状况为好者(<70岁,HR=5.382,95%CI:3.263~8.876;70~<80岁,HR=3.536,95%CI:1.070~11.686;≥80岁,HR=3.043,95%CI:1.827~5.066)。结论 老年人自评健康状况与死亡风险存在关联,自评健康状况为不好的老年男性死亡风险较高。

Objective To investigate the association between self-rated health status and mortality risk, and to evaluate the predictive value of self-rated health status for mortality risk among the elderly. Methods Based on the China Health and Retirement Longitudinal Study (CHARLS) database, data of sociodemographic information, self-rated health status and mortality of the elderly aged 60 years and older were collected from 2011 to 2018. The association between self-rated health status and mortality risk among the elderly was analyzed using a multivariable Cox proportional risk regression model. Results Totally 4 850 individuals were included, with an median age of 65 (interquartile range, 8) years. There were 2 485 males (51.24%) and 2 365 females (48.76%). There were 877 individuals (18.08%) rated their health as good, 2 078 individuals (42.85%) as general, 1 895 individuals (39.07%) as poor. A total of 28 955 person-years were followed up, with an average follow-up of 5.97 years per person. There were 855 deaths by the end of follow-up in 2018, and the median survival time was 7 (interquartile range, 3) years. Multivariable Cox propor⁃ tional risk regression analysis showed that there were interactive effects of age, sex and self-rated health status on mor⁃ tality, respectively (both P<0.05). The results of gender-stratified analysis showed that there was no significant associa⁃ tion between self-rated health status and mortality risk in old women (P>0.05). The mortality risk was higher in old men with poor self-rated health than with good self-rated health (<70 years, HR=5.382, 95%CI: 3.263-8.876;70 to 79 years, HR=3.536, 95%CI: 1.070-11.686;≥80 years, HR=3.043, 95%CI: 1.827-5.066). Conclusion There is an asso⁃ ciation between self-rated health status and mortality risk among the elderly, the old men with poor self-rated health had a higher mortality risk.