Kelfve Susanne, Thorslund Mats, Lennartsson Carin
Department of Sociology, Stockholm University, Stockholm, Sweden.
Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Eur J Ageing. 2013 Mar 26;10(3):237-245. doi: 10.1007/s10433-013-0275-7. eCollection 2013 Sep.
Surveys of the oldest old population are associated with several design issues. Place of residence and possible physical or cognitive impairments make it difficult to maintain a representative study population. Based on a Swedish nationally representative survey among individuals 77+, the present study analyze the potential bias of not using proxy interviews and excluding the institutionalized part of the population in surveys of the oldest old. The results show that compared to directly interviewed people living at home, institutionalized and proxy interviewed individuals were older, less educated and more likely to be female. They had more problems with health, mobility and ADL, and a significantly increased mortality risk. If the study had excluded the institutionalized part of the population and/or failed to use proxy interviews, the result would have been severely biased and resulted in underestimated prevalence rates for ADL, physical mobility and psychologic problems. This could not be compensated for weighting the data by age and sex. The results from this study imply that accurate population estimates require a representative study population, in which all individuals are included regardless of their living conditions, health status, and cognitive ability.
对高龄老人群体的调查存在若干设计问题。居住地点以及可能存在的身体或认知障碍使得维持具有代表性的研究群体变得困难。基于一项针对瑞典全国77岁及以上人群的具有代表性的调查，本研究分析了在高龄老人调查中不采用代理访谈以及排除机构养老人群所产生的潜在偏差。结果表明，与直接接受访谈的居家老人相比，机构养老和通过代理访谈的个体年龄更大、受教育程度更低且女性比例更高。他们在健康、行动能力和日常生活活动方面存在更多问题，死亡风险也显著增加。如果该研究排除了机构养老人群且/或未采用代理访谈，结果将出现严重偏差，导致日常生活活动、身体行动能力和心理问题的患病率被低估。这无法通过按年龄和性别对数据进行加权来弥补。本研究结果表明，准确的人口估计需要一个具有代表性的研究群体，其中所有个体都应被纳入，无论其生活条件、健康状况和认知能力如何。
