Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China.
School of Public Health, Fudan University, Shanghai, China.
Front Public Health. 2023 Jan 20;10:1098794. doi: 10.3389/fpubh.2022.1098794. eCollection 2022.
Prevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed.
We used survey data of a prospective 10-year cohort (2008-2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project.
There were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, < 0.001). Weibull regression suggested that FL ( < 0.001), abnormal BADL ( < 0.001) and IADL ( < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival.
Prevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people.
功能障碍（FLs）和日常生活活动受限（ADL）的发生率给老年人的健康带来了沉重负担。本研究按性别分层，旨在探讨 FL 和 ADL 对中国老年人死亡率的影响，并探讨其机制。
我们使用了中国长寿纵向研究（CLHLS）的前瞻性 10 年队列（2008-2018 年）的调查数据。主要结局是全因死亡率，自变量包括 FL、基本日常生活活动（BADL）和工具性日常生活活动（IADL）。协变量包括 CLHLS 项目中参与者的社会人口统计学特征、健康相关行为和健康状况。
有 967 名（19.20%）男性和 2235 名（32.36%）女性老年人存在功能障碍，他们的生存时间分别为 60.98（SE=0.66）和 55.19（SE=0.55）个月。有功能障碍的老年人的生存状况明显差于无功能障碍的老年人（Log-rank 检验， < 0.001）。Weibull 回归表明，FL（<0.001）、BADL 异常（<0.001）和 IADL 异常（<0.001）与老年人的生存呈负相关。进一步分析表明，BADL 和 IADL 在 FL 与老年人生存时间的关系中具有显著的中介作用；此外，对于女性老年人，BADL 还在 FL 对生存的影响中表现出显著的调节作用。
中国老年人的 FL 患病率较高，尤其是女性。BADL 和 IADL 的残疾以及 FL 与中国老年人的生存时间呈负相关。关于 FL 对生存的影响，BADL 和 IADL 具有显著的中介作用，而 BADL 的调节作用仅存在于女性。这些为实施维持老年人健康的策略提供了证据。
