我国老年人听力言语共残特征与原因及干预策略研究

Characteristics,Causes and Intervention Strategies of Hearing and Speech Disabilities among Older Adults in China

目的分析1987与2006年我国老年人听力言语残疾与其他残疾共残的流行情况及患病风险。方法利用1987与2006年两次全国残疾人抽样调查数据,对听力言语残疾与其他残疾的共残现状进行描述性统计分析,同时利用logistic回归模型探究听力言语残疾及其严重程度与其他残疾的关系。结果1987年至2006年,我国老年人听力言语残疾的标化现患率由14.34%降至10.96%。两重听力言语残疾+视力残疾的共残比例最高,依次为听力言语残疾+肢体、听力言语残疾+智力及听力言语残疾+精神残疾。控制社会人口学因素之后,1987年只有视力、肢体和智力残疾老年人的听力言语残疾患病风险分别是没有其他残疾老年人的3.09、1.53及2.62倍,2006年为2.07、1.23和1.61倍。1987年与视力、肢体、智力和精神共残的听力言语老年人的重度听力言语残疾患病风险分别是没有其他残疾听力言语残疾老年人的1.35、1.76、1.91及4.48倍,2006年为1.16、1.47、2.20和1.67倍。结论在我国20年间针对老年听力言语残疾防治工作取得重要进展的基础上,应强化多重残疾老年人口的康复照护工作,进一步完善初级卫生保健网络分类残疾的精准干预,着重关联性残疾的预防、筛查、跟踪、干预和效果评价工作。

Objective To examine the prevalence and risk factors associated with hearing and speech disabilities,as well as concurrent impairments,among older adults in China in 1987 and 2006.Methods Using data from the China National Sample Survey on Disability in 1987 and 2006,this study performed a descriptive analysis to assess the prevalence and distribution of hearing and speech disabilities among older adults,along with concurrent impairments.Additionally,logistic regression models were employed to identify the relationship between the prevalence and severity of hearing and speech disabilities and their co-occurrence with other forms of disabilities.Results From 1987 to 2006,the standardized prevalence of hearing and speech disabilities among older adults in China decreased from 14.34%to 10.96%.Among the types of concurrent disabilities,hearing and speech disabilities combined with visual impairments had the highest proportion,followed by hearing and speech disabilities combined with physical,intellectual and mental disabilities.After controlling for sociodemographic factors,in 1987,older adults with visual,physical and intellectual disabilities had 3.09,1.53,and 2.62 times the risk of developing hearing and speech disabilities compared to those without other disabilities,while in 2006,these risks decreased to 2.07,1.23 and 1.61 times,respectively.In 1987,the risk of severe hearing and speech disabilities for older adults with concurrent visual,physical,intellectual and mental disabilities was 1.35,1.76,1.91,and 4.48 times higher,respectively,than for those with only hearing and speech disabilities.By 2006,these risks had reduced to 1.16,1.47,2.20 and 1.67 times,respectively.Conclusion Over a span of 20 years,China has made notable advancements in the prevention and treatment of hearing and speech disabilities among older adults.However,there remains a need to reinforce rehabilitation services for older adults with multiple disabilities.Furthermore,targeted interventions for specific disabilities within the primary healthcare system should be improved,with a focus on enhancing disability prevention,early screening,continuous follow-up,timely intervention and comprehensive outcome evaluation.