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越南老年人功能残疾的患病率及相关因素:二次数据分析

Prevalence of functional disability and associated factors among older people in Vietnam: a secondary data analysis.

作者信息

Nguyen Trang Thi, Giang Long Thanh, Bui Thu Dai, Nguyen Nam Truong

机构信息

Institute of Social and Medical Studies, Ha Noi, Vietnam

Faculty of Economics, National Economics University, Hanoi, Vietnam.

出版信息

BMJ Open. 2025 Mar 26;15(3):e093566. doi: 10.1136/bmjopen-2024-093566.

Abstract

OBJECTIVES

To explore the prevalence of functional disabilities and associated factors among older people in Vietnam.

DESIGN

A cross-sectional survey of older people aged 60 years and over in Vietnam using a multistage sampling method.

SETTING

The study used weighted data from the Vietnam Ageing Survey in 12 provinces in Vietnam.

PARTICIPANTS

The study sample consists of 3183 men and women aged 60 years and over.

OUTCOME MEASURES

The study used the Katz Index of Independence in Basic Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL) to assess functional disabilities. Bivariate analyses and multivariate logistic regressions were used to explore the association between functional disability indicators and associated factors such as sociodemographic, health status, health behaviours and social participation.

RESULTS

The prevalence of ADL limitation, IADL limitation and both ADL/IADL limitations among older people were 44.6%, 35.2% and 26.3%, respectively. After adjustment, the associated factors for ADL limitation, including age (OR=1.04, 95% CI: 1.02 to 1.06), lower education (secondary school vs high school and above: OR=2.11, 95% CI: 1.34 to 3.33), lower wealth quintiles (lowest vs highest quintile: OR=2.36, 95% CI: 1.57 to 3.56), fair/poor/very poor self-rated health (vs good/very good: OR=5.40, 95% CI: 3.42 to 8.52), number of chronic diseases (OR=1.41, 95% CI: 1.24 to 1.62), depressive symptoms (OR=2.58, 95% CI: 1.84 to 3.67), receiving financial support (OR=1.47, 95% CI: 1.021 to 2.12) and lack of social participation (OR=1.97, 95% CI: 1.38 to 2.81). The associated factors for IADL limitation included age (OR=1.07, 95% CI: 1.05 to 1.09), lower education (no schooling/incomplete primary education vs high school and above: OR=2.29, 95% CI: 1.29 to 4.05), lower wealth quintiles (poorest vs wealthiest: OR=2.82, 95% CI: 1.76 to 4.52), not working (OR=3.24, 95% CI: 2.36 to 4.44), did not drink alcohol in the last 6 months (OR=1.56, 95% CI: 1.05 to 2.30), number of chronic diseases (OR=1.23, 95% CI: 1.05 to 1.44), depressive symptoms (OR=2.05, 95% CI: 1.53 to 2.75) and lack of social participation (OR=3.88, 95% CI: 2.64 to 5.71). The associated factors for both ADL/IADL limitations were age, lower education, lower wealth quintiles, not working, fair/poor/very poor self-rated health, number of chronic diseases, depressive symptoms, receiving financial support, and lack of social participation.

CONCLUSION

The prevalence of functional disabilities among older people in Vietnam was high. Functional disabilities were multifactorial, and the multicomponent interventions and policies for older people should focus on improving health literacy, preventing and managing depression and chronic diseases, and encouraging social participation.

摘要

目的

探讨越南老年人功能残疾的患病率及相关因素。

设计

采用多阶段抽样方法对越南60岁及以上老年人进行横断面调查。

地点

该研究使用了越南12个省份的越南老龄化调查加权数据。

参与者

研究样本包括3183名60岁及以上的男性和女性。

观察指标

该研究使用日常生活活动能力(ADL)的Katz独立性指数和工具性日常生活活动能力(IADL)来评估功能残疾。采用双变量分析和多变量逻辑回归来探讨功能残疾指标与社会人口学、健康状况、健康行为和社会参与等相关因素之间的关联。

结果

老年人中ADL受限、IADL受限以及ADL/IADL均受限的患病率分别为44.6%、35.2%和26.3%。调整后,ADL受限的相关因素包括年龄(OR=1.04,95%CI:1.02至1.06)、教育程度较低(初中与高中及以上:OR=2.11,95%CI:1.34至3.33)、财富五分位数较低(最低与最高五分位数:OR=2.36,95%CI:1.57至3.56)、自我评定健康状况为一般/差/非常差(与良好/非常好相比:OR=5.40,95%CI:3.42至8.52)、慢性病数量(OR=1.41,95%CI:1.24至1.62)、抑郁症状(OR=2.58,95%CI:1.84至3.67)、接受经济支持(OR=1.47,95%CI:1.021至2.12)以及缺乏社会参与(OR=1.97,95%CI:1.38至2.81)。IADL受限的相关因素包括年龄(OR=1.07,95%CI:1.05至1.09)、教育程度较低(未上学/小学未毕业与高中及以上相比:OR=2.29,95%CI:1.29至4.05)、财富五分位数较低(最贫困与最富裕相比:OR=2.82,95%CI:1.76至4.52)、未工作(OR=3.24,95%CI:2.36至4.44)、过去6个月未饮酒(OR=1.56,95%CI:1.05至2.30)、慢性病数量(OR=1.23,95%CI:1.05至1.44)、抑郁症状(OR=2.05,95%CI:1.53至2.75)以及缺乏社会参与(OR=3.88,95%CI:2.64至5.71)。ADL/IADL均受限的相关因素包括年龄、教育程度较低、财富五分位数较低、未工作、自我评定健康状况为一般/差/非常差、慢性病数量、抑郁症状、接受经济支持以及缺乏社会参与。

结论

越南老年人功能残疾的患病率较高。功能残疾是多因素的,针对老年人的多成分干预措施和政策应侧重于提高健康素养、预防和管理抑郁症及慢性病,以及鼓励社会参与。

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