Qi S G, Wang Z H, Wang L M, Wang H, Zhang H, Li Z X
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050; China.
School of Public Health, Peking University, Beijing 100083, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Mar 10;40(3):272-276. doi: 10.3760/cma.j.issn.0254-6450.2019.03.004.
To analyze the decline of activities of daily living (ADL) ability and influencing factors over a period of 2 years in community-dwelling older adults in China. The study subjects were from the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China of 2015-2017 to select the samples. In 2015, a total of 23 803 community- dwelling residents adults, aged ≥60 years old, came from both urban and rural areas, were selected through a stratified multi-stage cluster sampling in 6 provinces and joint baseline survey. The follow-up was conducted in 2017 to collect the related information using the same questionnaires and examinations. Finally, 18 785 elderly people were included in this analysis after excluding those who were died, failed to follow up, had incomplete data cases or defined as ADL disability at baseline survey. The post-stratification weight on the sample data was done by using the 6(th) national population census data as the standard, the rates of ADL/basic activities of daily living (BADL)/instrumental activities of daily living (IADL) disabilities over 2 years were calculated and compared among the elderly with different characteristics. Multiple logistic regression models were used to analyze the factors associated with BADL/IADL disabilities. During the 2-year follow-up, ADL disability developed in 1 959 participants with a rate of 12.0 (1.6 for BADL disability and 10.4 for IADL disability only). Multivariate logistic regression analysis showed that the risk factors for BADL disability included increased age, obesity, comorbidity and cognitive impairment. The risk factors for only IADL disability included increased age, being female, lower weight and cognitive impairment. Compared with illiterates, the educated had lower risk for only IADL disability. Compared with those with normal weight, overweight and obese old people had lower risk for only IADL disabilities. Increased age and cognitive impairment were associated with the increased risk for BADL and IADL disabilities. Older people with comorbidities had higher risk for BADL disability. Obesity increased the risk of BADL disability, but decreased the risk for IADL disability in older people. Women had a higher risk for IADL disability compared with men. Being educated was associated with lower risk of IADL disability.
分析中国社区老年人2年内日常生活活动(ADL)能力的下降情况及其影响因素。研究对象来自2015 - 2017年中国老年人神经退行性疾病预防与干预项目的样本。2015年,通过在6个省份进行分层多阶段整群抽样,共选取了23803名年龄≥60岁的城乡社区居民成年人进行联合基线调查。2017年进行随访,使用相同的问卷和检查收集相关信息。最终,排除死亡、失访、数据不完整或在基线调查时被定义为ADL残疾的人群后,18785名老年人纳入本分析。以第6次全国人口普查数据为标准对样本数据进行事后分层加权,计算并比较不同特征老年人2年内ADL/基本日常生活活动(BADL)/工具性日常生活活动(IADL)残疾率。采用多因素logistic回归模型分析与BADL/IADL残疾相关的因素。在2年随访期间,1959名参与者出现ADL残疾,发生率为12.0(BADL残疾率为1.6,仅IADL残疾率为10.4)。多因素logistic回归分析显示,BADL残疾的危险因素包括年龄增加、肥胖、合并症和认知障碍。仅IADL残疾的危险因素包括年龄增加、女性、体重较低和认知障碍。与文盲相比,受过教育者仅IADL残疾的风险较低。与体重正常者相比,超重和肥胖老年人仅IADL残疾的风险较低。年龄增加和认知障碍与BADL和IADL残疾风险增加相关。患有合并症的老年人BADL残疾风险较高。肥胖增加了老年人BADL残疾的风险,但降低了IADL残疾的风险。女性IADL残疾风险高于男性。受过教育与IADL残疾风险较低相关。