Chen Huiying, Xu Xinpeng, Jia Cangcang, Gu Hai, Zhang Lu, Yi Yang
Research Center for Health Policy and Management, Nanjing University, Nanjing 210093, China.
School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Healthcare (Basel). 2023 Jun 14;11(12):1747. doi: 10.3390/healthcare11121747.
This study worked to investigate the effect of household polluting fuel use (HPFU), as an indicator of household air pollution exposure, on frailty among older adults in rural China. Additionally, this study aimed to examine the moderating effect of healthy lifestyle behaviors on the aforementioned association. This study employed cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, which conducted nationally representative sampling of older adults from 23 provinces in mainland China. The frailty index was calculated using 38 baseline variables that assessed health deficits through questionnaire surveys and health examinations. A total of 4535 older adults aged 65 years and above were included in our study, among whom, 1780 reported using polluting fuels as their primary household cooking fuel. The results of regression analyses and multiple robustness checks indicated a significant increase in the frailty index due to HPFU. This environmental health threat was more profound among women, illiterate individuals, and low-economic-status groups. Moreover, healthy dietary and social activities had significant moderating effects on the association between HPFU and frailty. HPFU can be regarded as a risk factor for frailty among older adults in rural China, with its effects exhibiting socio-economic disparities. The adoption of healthy lifestyle behaviors can alleviate the frailty associated with HPFU. Our findings underscore the significance of using clean fuels and improving household air quality for healthy aging in rural China.
本研究旨在调查作为家庭空气污染暴露指标的家庭使用污染性燃料（HPFU）对中国农村老年人衰弱的影响。此外，本研究旨在检验健康生活方式行为对上述关联的调节作用。本研究采用了2018年中国健康与养老追踪调查的横断面数据，该调查对中国大陆23个省份的老年人进行了具有全国代表性的抽样。衰弱指数是通过38个基线变量计算得出的，这些变量通过问卷调查和健康检查来评估健康缺陷。我们的研究共纳入了4535名65岁及以上的老年人，其中1780人报告使用污染性燃料作为其主要家庭烹饪燃料。回归分析和多项稳健性检验的结果表明，HPFU会导致衰弱指数显著上升。这种环境卫生威胁在女性、文盲个体和低经济地位群体中更为严重。此外，健康的饮食和社交活动对HPFU与衰弱之间的关联具有显著的调节作用。HPFU可被视为中国农村老年人衰弱的一个风险因素，其影响存在社会经济差异。采取健康的生活方式行为可以减轻与HPFU相关的衰弱。我们的研究结果强调了在中国农村使用清洁燃料和改善家庭空气质量对健康老龄化的重要性。
