Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
Unit of Epidemiology, Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.
J Gerontol A Biol Sci Med Sci. 2018 Nov 10;73(12):1701-1707. doi: 10.1093/gerona/gly010.
To estimate the prevalence of disability during the last 3 years prior to death among the oldest-old (≥80 years) in China.
We used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative study of the oldest-old in China. The analytic sample included 23,934 decedents who died between 1998 and 2014 and had at least one interview within the last 3 years of life. Disability was defined as being incontinent or needing assistance in performing one or more of five other essential activities (bathing, transferring, dressing, eating, and toileting).
About 57.8% (weighted) of the study decedents were female. The prevalence of disability increased modestly from 36 months to 24 months prior to death (20% to 23%), more rapidly from 24-months to 12-months before death (23% to 31%), and substantially from 12 months before death to the last month of life (31% to 48%). The disability rates were lowest for participants who died between 80 and 89 years, intermediate for those who died between 90 and 99 years, and highest for those who died at age 100 or older, although the patterns over the 3-year period were comparable for the three age groups. At each time point prior to death, a higher percentage of women was disabled than men.
In this large nationally representative sample of the oldest-old in China, the prevalence of disability during the 3 years prior to death is high and is greater in women than men and those who die at the oldest ages.
估计中国最年长人群（≥80 岁）在去世前 3 年内的残疾发生率。
我们使用了中国长寿纵向研究（CLHLS）的数据，这是一项针对中国最年长人群的全国性研究。分析样本包括 1998 年至 2014 年间死亡且在生命最后 3 年内至少接受过一次访谈的 23934 名死者。残疾定义为失禁或在进行五项基本活动（洗澡、转移、穿衣、进食和如厕）中的一项或多项活动时需要帮助。
研究死者中约有 57.8%（加权）为女性。残疾的发生率从死亡前 36 个月到 24 个月缓慢增加（20%增加到 23%），从 24 个月到 12 个月前迅速增加（23%增加到 31%），从 12 个月前到生命的最后一个月大幅增加（31%增加到 48%）。残疾率在 80 至 89 岁之间死亡的参与者中最低，在 90 至 99 岁之间死亡的参与者中处于中间水平，在 100 岁或以上死亡的参与者中最高，尽管在 3 年期间三个年龄组的模式相似。在死亡前的每个时间点，女性残疾的比例都高于男性。
在这项针对中国最年长人群的大型全国代表性样本中，在去世前 3 年内的残疾发生率很高，女性高于男性，且在最年长的年龄组中更高。
