Zhan Y Y, Han Y F, Fang Y
Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen 361000, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Jun 10;42(6):1024-1029. doi: 10.3760/cma.j.cn112338-20200907-01133.
To understand and quantify the main influencing factors related to disability free life expectancy (DFLE) among Chinese elderly. Using publicly available data from the Chinese Longitudinal Healthy Longevity Survey (2011-2018), we fitted multi-states Markov model and microsimulation to estimate DFLE at age 65, life expectancy (LE) at age 65 and proportion of DFLE to LE (DFLE/LE) at age 65. We calculated 95% by Bootstrap. DFLE of the Chinese elderly aged 65 was 14.27 (95%: 13.85-14.74) years, higher in female than male and higher in elderly with higher economic status. DFLE/LE at age 65 was 86.33% (95%: 85.52%-87.18%), higher in male than female and rural than urban. The risk factors of DFLE include not undergoing physical examination, inadequate fruit/vegetable intake, smoking, and feeling stress, leading to 0.74, 0.41, 0.62, 0.12 years of DFLE lost for male, and 0.82, 0.42, 0.19, 0.20 years of DFLE lost for female, respectively. Eliminating these risk factors can improve DFLE at age 65 by 1.73 years for male and 1.45 years for female. Policies targeting male elderly and the elderly with lower economic status, and measures promoting physical examination and adequate fruit/vegetable intake, relieving stress and banning smoking can substantially improve DFLE of Chinese elderly.
了解并量化中国老年人无残疾预期寿命(DFLE)的主要影响因素。利用中国健康与养老追踪调查(2011 - 2018)的公开数据,我们拟合了多状态马尔可夫模型和微观模拟,以估计65岁时的无残疾预期寿命、65岁时的预期寿命(LE)以及65岁时无残疾预期寿命占预期寿命的比例(DFLE/LE)。我们通过Bootstrap方法计算了95%置信区间。65岁中国老年人的无残疾预期寿命为14.27年(95%置信区间:13.85 - 14.74年),女性高于男性,经济状况较高的老年人高于经济状况较低的老年人。65岁时无残疾预期寿命占预期寿命的比例为86.33%(95%置信区间:85.52% - 87.18%),男性高于女性,农村高于城市。无残疾预期寿命的风险因素包括未进行体检、水果/蔬菜摄入量不足、吸烟和感到压力,分别导致男性无残疾预期寿命损失0.74年、0.41年、0.62年、0.12年,女性无残疾预期寿命损失0.82年、0.42年、0.19年、0.20年。消除这些风险因素可使65岁男性的无残疾预期寿命提高1.73年,女性提高1.45年。针对男性老年人和经济状况较低的老年人的政策,以及促进体检和充足水果/蔬菜摄入量、缓解压力和禁止吸烟的措施,可大幅提高中国老年人的无残疾预期寿命。