China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China.
Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia.
JMIR Public Health Surveill. 2023 Aug 10;9:e43612. doi: 10.2196/43612.
China is facing a rapidly expanding aging population. Insights into the health status of older adults are of great significance for health resource allocation and health care provision to this population.
With the goal of providing a comprehensive understanding of the health status of older adults and to inform potential interventions, we investigated the level of disability and identified risk factors associated with disability among the older population (aged ≥60 years) living in China.
A total of 8467 older adults living in the Chinese city of Shenzhen were enrolled in this cross-sectional study. We used a multidimensional ability assessment survey, which assessed their activities of daily living (ADL; including eating, bathing, grooming, dressing, defecation control, urination control, using a toilet unaided, transfer, flat-ground walking, stair activity), mental status (including cognitive function, aggressive behavior, depression symptoms), sensory and communication (including consciousness level, vision, hearing, communication), and social participation (including living, working, time/space orientation, distinguish persons, social communication) abilities. The impact of demographic risk factors on ability levels was analyzed using ordinal logistic regression. The correlations between the four dimensions of ability mentioned above were analyzed using Spearman correlation analysis.
A total of 7766 participants were effectively assessed. The participants' average age was 70.64 (SD 8.46) years comprising 56.53% females. The overall ability level was classified as mildly, moderately, and severely impaired for 27.57% (n=2141), 2.83% (n=220), and 4.28% (n=332) of the 7766 participants, respectively. With increasing age, the proportion of impaired participants increased from 17.62% (365/2071) in the age group 60-64 years to 91.3% (253/277) in the age group above 90 years (P<.001), corresponding to an approximate 10% rise for every 5-year age increment. The odds of having more severe overall ability impairment in females was 1.15 times that in males (odds ratio [OR] 1.15, 95% CI 1.04-1.28). Participants who were divorced or widowed had a higher risk of more severe overall ability impairment than those currently married (OR 1.98, 95% CI 1.68-2.33). Participants living with nonrelatives had an increased risk of more severe overall ability impairment than those living alone (OR 2.38, 95% CI 1.46-3.91). Higher education level was a protective factor of overall ability impairment (college degree or above: OR 0.32, 95% CI 0.24-0.42). The four dimensions of ability assessed were significantly correlated; a low score for ADL was significantly correlated with poorer mental status, sensory and communication, and social participation (all P<.001).
The proportion of disability among Chinese older adults increases with age, being female, having lower education levels, being divorced or widowed, and living with nonrelatives. Impairment in ADL ability is significantly correlated with poor mental status, social participation, and sensory and communication abilities. A holistic approach to improving the health of the older population is recommended in China.
中国正面临着迅速扩大的老龄化人口。了解老年人的健康状况对于为这一人群分配卫生资源和提供卫生保健具有重要意义。
旨在全面了解中国老年人口（年龄≥60 岁）的健康状况，并确定与残疾相关的风险因素，为潜在的干预措施提供信息。
本横断面研究纳入了居住在中国深圳的 8467 名老年人。我们使用多维能力评估调查评估了他们的日常生活活动（ADL；包括饮食、洗澡、梳妆、穿衣、排便控制、排尿控制、使用厕所、转移、平地行走、楼梯活动）、精神状态（包括认知功能、攻击行为、抑郁症状）、感觉和沟通（包括意识水平、视力、听力、沟通）以及社会参与（包括生活、工作、时间/空间定向、辨别人员、社会沟通）能力。使用有序逻辑回归分析人口统计学风险因素对能力水平的影响。使用 Spearman 相关分析评估上述四个维度之间的相关性。
共有 7766 名参与者得到有效评估。参与者的平均年龄为 70.64（SD 8.46）岁，其中 56.53%为女性。总体能力水平分为轻度、中度和重度受损，分别占 7766 名参与者的 27.57%（n=2141）、2.83%（n=220）和 4.28%（n=332）。随着年龄的增长，受损参与者的比例从 60-64 岁年龄组的 17.62%（365/2071）增加到 90 岁以上年龄组的 91.3%（253/277）（P<.001），每增加 5 岁，比例增加约 10%。女性总体能力严重受损的可能性是男性的 1.15 倍（比值比[OR] 1.15，95%置信区间 1.04-1.28）。与目前已婚的参与者相比，离婚或丧偶的参与者更有可能出现严重的总体能力受损（OR 1.98，95%置信区间 1.68-2.33）。与独居者相比，与非亲属同住的参与者更有可能出现严重的总体能力受损（OR 2.38，95%置信区间 1.46-3.91）。较高的教育水平是总体能力受损的保护因素（大专及以上学历：OR 0.32，95%置信区间 0.24-0.42）。评估的四个能力维度之间存在显著相关性；ADL 得分较低与精神状态、感觉和沟通以及社会参与较差显著相关（均 P<.001）。
中国老年人口的残疾比例随年龄增长而增加，与性别为女性、教育水平较低、离婚或丧偶以及与非亲属同住有关。ADL 能力受损与较差的精神状态、社会参与和感觉及沟通能力显著相关。建议中国采取整体方法改善老年人口的健康状况。
