通过结构方程模型探讨老年人活力的测量方法

A study of the indicators for vitality measurement based on structural equation model analysis

目的通过结构方程模型探讨老年人内在能力中活力指示变量的构建方法。方法针对2020年5月至2022年5月于北京医院老年科就诊患者的老年综合评估数据,收集常用于测量活力及活动能力的7个测量变量(体质指数、体重丢失、小腿围、握力、4m步速、起立-行走、起立-坐下)。通过结构方程模型,以活动能力为参照,应用探索性因子分析、验证性因素分析及相关性分析探索并验证活力的指示变量。结果探索性因子分析可知以上7个变量可归纳为两个潜变量,分别为活力、活动能力;其中体质指数、体重丢失、小腿围可共同反映活力;握力、4m步速、起立-行走、起立-坐下可共同反映活动能力。验证性因素分析及模型检验提示测量模型构建合理,活力及活动能力指示变量分配合理[卡方和自由度比值(χ^(2)/df)=35/13,比较拟合指数(CFI)=0.96,近似误差平方根(RMESEA(95%CI)=0.06(0.04,0.08)。指示变量相关性研究结果显示,握力-活力指示变量相关性较低,握力-活动能力的指示变量相关性较好(ρ_(握力/活动能力)=0.33,ρ_(握力/活力)=0.21)。结论老年人内在能力中的活力可用体质指数、体重丢失及小腿围测量;相比活力,握力更适合用于反映老年人的活动能力。

Objective To use structural equation modeling to identify the indicator variables of intrinsic ability vitality among the elderly population.Methods The study collected data on seven variables commonly used to measure vitality and mobility,including body mass index,weight loss,calf circumference,grip strength,gait speed at 4 m,up and go,and up and sit,from the comprehensive geriatric assessment(CGA)of patients admitted to the Department of Geriatrics of Beijing Hospital between May 2020 and May 2022.The study used a structural equation model to explore and verify the indicator variables of activity,utilizing exploratory factor analysis,confirmatory factor analysis,and correlation analysis.Results The study conducted an exploratory factor analysis on seven variables,which resulted in two latent variables named vitality and locomotion.Body mass index,weight loss,and calf circumference were found to reflect vitality,while grip strength,4 m-walking speed,time up and go test,and standing up and down test were found to reflect locomotion.Confirmatory factor analysis indicated that the measurement model was well-constructed and the indicator variables of vitality and locomotion were reasonably assigned[χ^(2)/df=35/13,CFI=0.96,RMSEA(95%CI)=0.06(0.04,0.08)].Correlation analysis showed that grip strength had a stronger correlation with locomotion-related variables than vitality-related variables(for grip strength and locomotion=0.33,for grip strength and vitality=0.21).Conclusions The intrinsic ability and vitality of elderly individuals can be assessed through various means,including body mass index,weight loss,and calf circumference.However,grip strength is considered a more appropriate measure for reflecting locomotion rather than overall vitality.