Institute of Wenzhou, Zhejiang University, Wenzhou, Zhejiang, China; School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China.
Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Exp Gerontol. 2024 Sep;194:112490. doi: 10.1016/j.exger.2024.112490. Epub 2024 Jun 18.
Adults with cognitive impairment are prone to living alone in large numbers but receive relatively little attention. This study aimed to evaluate whether living alone with cognitive impairment was associated with a higher burden of functional disability but lack of informal care.
982 observations of adults living alone with cognitive impairment and 50,695 observations of adults living with others and with normal cognition were identified from 4 waves (2011/2012, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS). A matched comparator was selected using propensity score matching (1:2). Functional disability included disability in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and mobility. The time of receiving informal care was measured in monthly hours.
Adults living alone with cognitive impairment demonstrated significantly higher odds ratio of ADL disability (OR = 1.59, 95 % CI: 1.30, 1.95), IADL disability (OR = 1.19, 95 % CI: 1.00, 1.44), mobility disability (OR = 1.38, 95 % CI: 1.12, 1.70), but received fewer hours of informal care (β = -127.7 h per month, standard error = 25.83, P < 0.001), compared to the adults living with others and with normal cognition.
This study highlights the high burden of functional disability but low coverage of informal care among Chinese adults living alone with cognitive impairment and calls for more resources to be allocated to this vulnerable subpopulation to improve the functional health and to increase the provision of long-term care services.
认知障碍的成年人大量独居，但得到的关注相对较少。本研究旨在评估认知障碍的成年人独居是否与更高的功能残疾负担但缺乏非正式护理有关。
从中国健康与退休纵向研究（CHARLS）的 4 个波次（2011/2012、2013、2015 和 2018 年）中，共识别出 982 例独居认知障碍成年人和 50695 例与他人一起居住且认知正常的成年人的观察结果。使用倾向评分匹配（1:2）选择匹配对照。功能残疾包括日常生活活动（ADL）、工具性日常生活活动（IADL）和移动能力障碍。接受非正式护理的时间以每月小时数测量。
独居认知障碍的成年人表现出更高的 ADL 残疾（OR=1.59，95%CI：1.30，1.95）、IADL 残疾（OR=1.19，95%CI：1.00，1.44）、移动能力残疾（OR=1.38，95%CI：1.12，1.70）的优势比，但接受的非正式护理时间更少（β=-127.7 小时/月，标准误差=25.83，P<0.001），与与他人一起居住且认知正常的成年人相比。
本研究强调了中国独居认知障碍成年人功能残疾负担高但非正式护理覆盖不足的问题，并呼吁为这一弱势群体分配更多资源，以改善其功能健康状况，并增加长期护理服务的提供。
