我国中老年人慢性病共病患病率的变化趋势及影响因素分析

Analysis on Trends and Influencing Factors of Prevalence of Multimorbidity of Chronic DiseasesAmong Middle-aged and Elderly People in China

目的:分析我国中老年人慢性病共病患病率的变化趋势及影响因素,为制定慢性病共病防治干预和管理措施提供参考。方法:利用中国健康与养老追踪调查的5期数据,以74954名中老年人为研究对象,根据慢性病种类将慢性病共病划分为躯体疾病共病和躯体疾病-精神障碍共病两类,分别分析中老年人两类慢性病共病患病率的变化趋势,使用广义估计方程模型探究躯体疾病共病、躯体疾病-精神障碍共病患病率的影响因素。结果:2011-2020年,我国中老年人躯体疾病共病患病率由17.7%上升至29.6%,躯体疾病-精神障碍共病患病率由27.9%上升至33.3%。在婚、受教育程度高、居住在城市是躯体疾病共病的危险因素,却是躯体疾病-精神障碍共病的保护因素,高龄、家庭人均支出高、无工作则是躯体疾病共病和躯体疾病-精神障碍共病共同的危险因素。结论:我国中老年人躯体疾病共病患病率和躯体疾病-精神障碍共病患病率总体呈持续上升趋势,应根据其不同的社会人口学特征和社会经济地位分布特点,尤其关注女性、居住在农村、受教育程度低、无医疗保险中老年人群体的躯体疾病-精神障碍共病状况,制定有针对性的综合干预策略和健康管理措施。

Objective:To analyze the trends and influencing factors of the prevalence of multimorbidity of chronic diseases among middle-aged and elderly people in China,so as to provide references for the formulation of intervention and management measures for the prevention and treatment of multimorbidity.Methods:Using data from 74954 middle-aged and elderly people in five phases of China health and retirement longitudinal study,the multimorbidity was divided into two categories including physical multimorbidity and physical-mental multimorbidity,the changing trends of them were analyzed,and influencing factors were explored using the generalized estimating equation model.Results:The prevalence of physical multimorbidity among middle-aged and elderly people in China rose from 17.7%to 29.6%,and the prevalence of physical-mental multimorbidity rose from 27.9%to 33.3%in 2011-2020.The results showed that being married,highly educated,and residing in the city were risk factors for physical multimorbidity,and they were protective factors for physical-mental multimorbidity.Older age,high per capita household expenditure,and unemployment were common risk factors for physical multimorbidity and physical-mental multimorbidity.Conclusion:The prevalence of physical multimorbidity and physical-mental multimorbidity among middle-aged and elderly people in China is continuously increasing.They exhibit different social demographic characteristics and socioeconomic status distributions,and targeted comprehensive intervention strategies and health management measures should be developed based on their different distribution characteristics,especially for physical-mental multimorbidity of females and middle-aged and elderly people living in rural areas,with low education levels and no medical insurance.