老年人自我忽视行为发展轨迹及其影响因素

Development trajectories and influencing factors of self-neglect behavior in older adults

目的识别老年人自我忽视行为发展轨迹,并探索相关影响因素。方法基于中国老年健康影响因素跟踪调查(Chinese longitudinal healthy longevity survey,CLHLS)2011—2018年3次调查数据构建固定队列,选取居住环境、生活方式、社会交往、医疗保健4个维度共8个变量评价自我忽视,采用组基轨迹模型识别老年人自我忽视行为发展轨迹,采用多项式Logistic回归模型探索其影响因素。统计软件为Stata16.1。结果最终纳入2754名≥60岁老年人。根据组基轨迹模型老年人自我忽视行为发展轨迹可划分为平稳-较低组(n=268,9.7%),下降-中等组(n=2224,80.8%),下降-较高组(n=262,9.5%)。多项式Logistic回归结果显示:与平稳-较低组相比,农村(B=1.116,OR=3.053,95%CI=2.278~4.091),日常生活能力得分较高(B=0.137,OR=1.147,95%CI=1.046~1.258)是下降-中等组的危险因素;教育年限1~6年(B=-0.398,OR=0.672,95%CI=0.469~0.963)、>6年(B=-1.072,OR=0.342,95%CI=0.229~0.513),在婚(B=-0.476,OR=0.621,95%CI=0.444~0.870),自评健康好(B=-0.808,OR=0.446,95%CI=0.213~0.932),健康变化变好(B=-0.704,OR=0.495,95%CI=0.320~0.766),自评经济一般(B=-1.065,OR=0.345,95%CI=0.148~0.802)、自评经济好(B=-1.634,OR=0.195,95%CI=0.082~0.467),认知功能得分高(B=-0.142,OR=0.867,95%CI=0.798~0.942)是下降-中等组的保护因素。除以上因素外,与平稳-较低组相比,年龄75~89岁(B=0.481,OR=1.617,95%CI=1.057~2.473)是下降-较高组的危险因素。结论本研究识别出了3种老年人自我忽视行为发展轨迹,提示躯体健康、经济状况等是老年人自我忽视发展轨迹的影响因素。

ObjectiveTo identify the development trajectories of self-neglect behavior in older adults and explore the associated influencing factors.MethodsA fixed cohort was constructed based on the data from three surveys of Chinese longitudinal healthy longevity survey(CLHLS)from^(2)011 to 2018.A total of eight variables from 4 dimensions including living environment,lifestyle,social interaction,and health care were selected to evaluate self-neglect.Group-based trajectory model was used to identify the development trajectory of self-neglect behavior in the older adults,and polynomial Logistic regression model was used to explore its influencing factors by Stata 16.1.ResultsFinally,2754 older adults aged 60 and above were included.The development trajectory of self-neglect behavior in older adults,based on the group-based trajectory model,can be classified into stable-low group(n=268,9.7%),descending-moderate group(n=2224,80.8%),and decreasing-high group(n=262,9.5%).Polynomial Logistic regression showed that,compared with stable-low group,living in rural areas(B=1.116,OR=3.053,95%CI=2.278-4.091)and higher activities of daily living scores(B=0.137,OR=1.147,95%CI=1.046-1.258)were the risk factors of descending-moderate group.Education levels with 1-6 years(B=-0.398,OR=0.672,95%CI=0.469-0.963),>6 years(B=-1.072,OR=0.342,95%CI=0.229-0.513),being married(B=-0.476,OR=0.621,95%CI=0.444-0.870),self-reported good health(B=-0.808,OR=0.446,95%CI=0.213-0.932),improved health status(B=-0.704,OR=0.495,95%CI=0.320-0.766),self-reported average economic status(B=-1.065,OR=0.345,95%CI=0.148-0.802),self-reported good economic status(B=-1.634,OR=0.195,95%CI=0.082-0.467),and a higher cognition score(B=-0.142,OR=0.867,95%CI=0.798-0.942)served as protective factors of descending-moderate group.In addition to the above factors,being in the age group of 75-89 years(B=0.481,OR=1.617,95%CI=1.057-2.473)was a risk factor for decreasing-high group compared to stable-low group.ConclusionsThree types of self-neglect behavior trajectories among older adults were identified in this study,suggesting that physical health and economy are the influencing factors of the development trajectory of self-neglect of the elderly.