重庆市九龙坡区60岁及以上老年人失能现况及影响因素分析

Current status and influencing factors of disability among elderly aged 60 and above in Jiulongpo district of Chongqing municipality

目的了解重庆市九龙坡区60岁及以上老年人失能现况及影响因素,为改善老年人健康状况,制定相关卫生政策提供参考及建议。方法2022年10—12月,采用多阶段分层整群随机抽样方法,在九龙坡区抽取600名60岁及以上老年人进行面对面电子问卷调查。调查内容主要包括基本人口学信息、日常生活能力情况、跌倒状况、个人健康行为方式和健康状况。采用Katz日常生活功能指数量表衡量调查对象失能状况,使用SPSS 25.0软件对数据进行统计分析,通过多因素Logistic回归分析失能的影响因素。结果600名调查对象平均年龄为(70.47±6.41)岁,16.67%的调查对象在过去1年内发生过跌倒,89.00%的调查对象经常进行体育锻炼,6.00%的调查对象自评健康状况为差。自述患脑血管病、心脏病、骨关节病、骨质疏松症、帕金森病和阿尔兹海默症的调查对象人数比例分别为4.50%、12.00%、7.83%、13.33%、0.33%、0.33%。调查对象失能发生率为7.17%(43/600)。6项日常生活能力有问题的老年人占比最高是控制大小便(2.50%),最低是穿衣和洗澡(1.33%)。多因素Logistics回归分析结果显示,80~岁年龄段的调查对象(OR=3.96,95%CI:1.85~8.50)、自评健康状况差(OR=19.49,95%CI:4.51~84.15)和自评健康状况一般(OR=7.56,95%CI:2.20~26.00)的调查对象、过去1年内发生过跌倒的调查对象(OR=2.97,95%CI:1.52~5.80)、自报患有脑血管病(OR=3.79,95%CI:1.18~12.17)和骨质疏松症(OR=4.17,95%CI:1.77~9.80)的调查对象更容易发生失能(P<0.05)。结论重庆市九龙坡区60岁及以上老年人日常生活活动能力失能率较高,应对80~岁年龄段、自评健康状况差、发生过跌倒、患有脑血管病和骨质疏松症的老年人积极开展针对性的早期预防和干预。

Objective To understand the current status and influencing factors of disability among elderly people aged 60 and above in Jiulongpo district,Chongqing,and to provide references and suggestions for improving elderly health and formula-ting relevant health policies.Methods From October to December 2022,600 elderly residents aged 60 and above were se-lected using a multistage stratified cluster random sampling method for face-to-face online questionnaire surveys.The survey included demographic information,abilities of daily living,fall history,personal health behaviors,and health status.The Katz Index of Independence in Activities of Daily Living was used to measure disability status,and SPSS 25.0 software was used for statistical analysis.Multivariate logistic regression analysis was employed to identify influencing factors of disabili-ty.Results The average age of the 600 participants was(70.47±6.41)years.In the past year,16.67%had fallen,89.00%regularly exercised,and 6.00%self-rated their health as poor.The proportions of participants reporting cerebro-vascular disease,heart disease,osteoarthritis,osteoporosis,Parkinson's disease,and Alzheimer's disease were 4.50%,12.00%,7.83%,13.33%,0.33%,and 0.33%,respectively.The disability rate was 7.17%(43/600).The highest pro-portion of activities of daily living problems was with bowel and bladder control(2.50%),and the lowest was with dressing and bathing(1.33%).Multivariate logistic regression analysis showed that participants aged 80 and above(OR=3.96,95%CI:1.85-8.50),those with poor self-rated health(OR=19.49,95%CI:4.51-84.15),those with average self-rated health(OR=7.56,95%CI:2.20-26.00),those who had fallen in the past year(OR=2.97,95%CI:1.52-5.80),and those with cerebrovascular disease(OR=3.79,95%CI:1.18-12.17)and osteoporosis(OR=4.17,95%CI:1.77-9.80)were more likely to be disabled(P<0.05).Conclusion The disability rate in activities of daily living a-mong the elderly in Jiulongpo district remains high.Early targeted prevention and intervention should be conducted for those aged 80 and above,those with poor self-rated health,those who have fallen,and those with cerebrovascular disease and os-teoporosis.