超越“欧洲健康鸿沟”:中东欧老年人的功能限制差异
Beyond the "European health divide": Functional limitation disparities among older adults in Central and Eastern Europe.
作者信息
Burns Shane D, Abuladze Liili, Sakkeus Luule
机构信息
Population Studies Center, University of Michigan, Ann Arbor, MI 48109, USA.
Estonian Institute for Population Studies, Tallinn University, 10120 Tallinn, Estonia.
出版信息
Arch Gerontol Geriatr. 2025 Sep;136:105908. doi: 10.1016/j.archger.2025.105908. Epub 2025 May 24.
OBJECTIVES
Countries in Central and Eastern Europe (CEE) generally have worse health outcomes than the rest of Europe, commonly referred to as the "European health divide". Regional specificities and historical pathways can shape health outcomes later in life, although variance of older adult functional limitation within CEE is understudied.
METHODS
We used wave 9 (2021-2022) data (n = 18,903) from the Survey of Health, Ageing and Retirement in Europe (SHARE) with mixed effects regression models to analyze difficulty with mobility, near vision, hearing, and episodic memory among those ages 65+ in the Baltic States (Estonia; Latvia; Lithuania), Visegrád Group (Czechia; Hungary; Poland; Slovakia), Former Yugoslavia (Croatia; Slovenia), and the Black Sea (Bulgaria; Romania) while accounting for demographic, socioeconomic, health, and social tie indicators.
RESULTS
Age-adjustments showed the highest difficulty rates of: mobility in Romania and Hungary, near vision in Latvia and Bulgaria, hearing in Estonia and Poland, and episodic memory in Poland and Croatia. Compared to the Baltic States, odds of reporting mobility difficulty were greater in the Black Sea but accounted for by socioeconomic factors. Fully adjusted odds of reporting near vision difficulty were lower in Visegrád Group and Former Yugoslavia. Fully adjusted odds of reporting hearing difficulty were lower in Visegrád Group, Former Yugoslavia, and the Black Sea. There were no regional differences in episodic memory.
DISCUSSION
Functional limitation disparities, which were largely shaped by socioeconomic factors, varied throughout CEE. These findings highlight the heterogenous health and long-term care needs of older adults throughout CEE.
目标
中东欧(CEE)国家的健康状况总体上比欧洲其他地区更差,这通常被称为“欧洲健康鸿沟”。尽管中东欧地区老年人功能受限的差异尚未得到充分研究,但地区特殊性和历史发展路径可能会影响晚年的健康状况。
方法
我们使用了欧洲健康、老龄化和退休调查(SHARE)第9波(2021 - 2022年)的数据(n = 18,903),通过混合效应回归模型分析了波罗的海国家(爱沙尼亚、拉脱维亚、立陶宛)、维谢格拉德集团(捷克、匈牙利、波兰、斯洛伐克)、前南斯拉夫(克罗地亚、斯洛文尼亚)以及黑海地区(保加利亚、罗马尼亚)65岁及以上人群在行动能力、近视力、听力和情景记忆方面的困难,同时考虑了人口统计学、社会经济、健康和社会关系指标。
结果
年龄调整后显示,以下方面的困难率最高:罗马尼亚和匈牙利的行动能力,拉脱维亚和保加利亚的近视力,爱沙尼亚和波兰的听力,以及波兰和克罗地亚的情景记忆。与波罗的海国家相比,黑海地区报告行动困难的几率更高,但这是由社会经济因素造成的。维谢格拉德集团和前南斯拉夫报告近视力困难的完全调整几率较低。维谢格拉德集团、前南斯拉夫和黑海地区报告听力困难的完全调整几率较低。情景记忆方面没有地区差异。
讨论
功能受限差异在很大程度上受社会经济因素影响,在整个中东欧地区各不相同。这些发现凸显了中东欧地区老年人不同的健康和长期护理需求。