基于活动受限的老年人健康预期寿命研究

Healthy life expectancy of the elderly in China based on activity limitation

目的了解我国老年人基于活动受限的健康预期寿命现状及其分布差异。方法利用中国老年健康影响因素跟踪调查(CLHLS)2011至2018年追踪数据,在总体活动受限指数(global activity limitation indicator,GALI)标准下通过多状态生命表法对我国老人的预期寿命、健康预期寿命、健康预期寿命占比进行测算。结果我国65岁老年人的无活动受限预期寿命为13.78岁,约4.84年(26.00%)的时间处于活动受限状态,低于基于ADL测算的无失能预期寿命。同时,我国老年人无活动受限预期寿命存在性别和城乡差异。女性老人的无活动受限预期寿命为13.89岁,男性老人无活动受限预期寿命为13.66岁,但女性的无活动受限预期寿命占比低于男性(69.22%VS 78.20%);城镇老年人的无活动受限预期寿命为13.86岁,农村老年人的无活动受限预期寿命为13.67岁,但城镇老年人的无活动受限预期寿命占比却低于农村老年人(72.47%VS 75.51%)。结论基于GALI的无活动受限预期寿命与ADL标准下的无失能预期寿命存在差异,比无失能健康预期寿命更能反映老年人的综合健康水平,拓展了对我国健康预期寿命的多维度理解,同时在年龄、性别、城乡间存在差异,需针对重点人群制定相应政策。

Objective To identify the current situation and distribution differences in the healthy life expectancy among Chinese elderly people.Methods Using the data of the Chinese Longitudinal Healthy Longevity Survey(CLHLS)Series from 2011 to 2018,the life expectancy,healthy life expectancy,and proportion of healthy life expectancy of Chinese elderly people were calculated using a multi-state life table method under the Global Activity Limitation Indicator(GALI)standard.Results The life expectancy without an activity limitation for Chinese people at 65 years of age was 13.78 years,with 4.84 years(26.00%)of activity limitation.It was lower than the life expectancy without disability calculated based on activities of daily living(ADL).Meanwhile,there were gender and urban-rural differences in the life expectancy of Chinese elderly people without an activity limitation.The life expectancy without an activity limitation in female and male elderly was 13.89 years and 13.66 years,respectively.However,the proportion of life expectancy without an activity limitation was lower in females than in males(69.22%vs 78.20%).The life expectancy without an activity limitation for urban and rural elderly was 13.86 years and 13.67 years,respectively.However,the proportion of life expectancy without an activity limitation was lower in urban elderly than in rural elderly(72.47%vs 75.51%).Conclusion There is a difference between the non-activity limited life expectancy based on GALI and the non-disability life expectancy under ADL standards,which better reflects the comprehensive health level of the elderly than the non-disability health life expectancy.This study expands the multidimensional understanding of healthy life expectancy in China,showing differences in age,gender,and urban-rural areas.Corresponding policies need to be formulated for key populations.