南方医科大学学报

南方医科大学学报 ›› 2021, Vol. 41 ›› Issue (11): 1719-1724.doi: 10.12122/j.issn.1673-4254.2021.11.18

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中国社区老年人衰弱发病及影响因素分析

王 琴，代雪梅，刘嘉琳，陈梓萱，余雨珂，刘秀秀，袁 萍   

  1. 四川大学华西公共卫生学院//华西第四医院流行病与卫生统计学系，四川 成都 610041
  • 出版日期:2021-11-20 发布日期:2021-12-10

Pravelance and risk factors of frailty in community-dwelling Chinese elderly population

WANG Qin, DAI Xuemei, LIU Jialin, CHEN Zixuan, YU Yuke, LIU Xiuxiu, YUAN Ping   

  1. Department of Epidemiology and Health Statistics//West China Fourth Hospital and West China School of Public Health, Sichuan University, Chengdu 610041, China
  • Online:2021-11-20 Published:2021-12-10

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摘要： 目的 了解我国社区60岁及以上老年人衰弱的发病情况，探讨其衰弱发生的主要影响因素。方法 利用中国健康和养老追踪调查2011~2015年的数据，以2011年基线调查时60岁及以上非衰弱的老年人建立研究队列，评估随访至2015年队列人群的衰弱发生情况；采用巢式病例对照研究方法，分析老年人衰弱发生的影响因素。结果 本研究队列人群共计随访14 351人年，随访期内共有248人发生衰弱，衰弱的发病密度为17.28/1000人年，男性（14.63/1000人年）低于女性（20.14/1000人年），年龄越大衰弱的发病密度越高（60~64、65~69、70~74、75~79、80岁及以上老年人衰弱的发病密度分别为：8.90/1000、16.77/1000、24.04/1000、35.27/1000、64.67/1000人年）。多因素条件logistic回归结果显示，有抑郁症状（OR=2.534，95% CI：1.714~3.748）、吸烟（OR=1.713，95% CI：1.081~2.715）、生活自理能力有困难（OR=1.684，95% CI：1.155~2.456）等因素是老年人衰弱发生的危险因素。未婚/离婚/丧偶（OR=0.432，95% CI：0.278~0.673）、认知功能得分高（OR=0.919，95% CI：0.870~0.970）、小学毕业（OR=0.453，95% CI：0.254~0.806）、饮酒（OR=0.520，95% CI：0.323~0.837）等因素是老年人衰弱发生的保护因素。 结论 我国60岁及以上社区老年人衰弱的发病率低于全球发病水平，不同性别、年龄之间老年人衰弱发病存在差异。有抑郁症状、吸烟、生活自理困难是我国社区老年人衰弱发生的主要危险因素。

关键词: 衰弱；发病密度；巢式病例对照研究；影响因素

Abstract: Objective To investigate the incidence of frailty in community-dwelling Chinese elderly population and explore the risk factors and protective factors of frailty in the elderly. Methods This study was conducted based on the 2011-2015 survey data provided by the China Health and Retirement Longitudinal Study (CHARLS). A research cohort was established consisting of non-debilitated elderly individuals aged 60 years and above at the 2011 baseline survey to assess the incidence of debilitation in the cohort population followed up till 2015. A nested case-control study was conducted to analyze the contributing factors to frailty in the elderly. Results In this study, the cohort population was followed up for a total of 14351 person-years. A total of 248 individuals had newly developed frailty during the follow-up period, resulting in an incidence of 17.28/1000 person-years; the incidence was lower in elderly men than in elderly women (14.63/1000 vs 20.14/1000 person-years). The incidence of debilitation increased progressively with ageing: 8.90/1000 person-years in 60-64 years group, 16.77/1000 person-years in 65-69 years group, 24.04/1000 person-years in 70-74 years group, and 64.67/1000 person-years in 80 years or older group. Multivariate conditional logistic regression analysis showed that depressive symptoms (OR=2.534, 95% CI: 1.714-3.748), smoking (OR=1.713, 95% CI: 1.081-2.715) and self-care difficulties (OR=1.684, 95% CI: 1.155-2.456) were the risk factors contributing to frailty in the elderly; the marital status (unmarried, divorced and widowed) (OR=0.432, 95%CI: 0.278- 0.673), a high cognitive function score (OR=0.919, 95%CI: 0.870-0.970), a primary school education (OR=0.453, 95%CI: 0.254-0.806) and drinking (OR=0.520, 95%CI: 0.323-0.837) were the protective factors against frailty in the elderly. Conclusions The incidence of frailty in community-dwelling Chinese elderly population is lower than the average incidence globally. The incidence of frailty in the elderly differs with gender and age, and depressive symptoms, smoking, and self-care difficulties are the main risk factors for frailty in the community-dwelling elderly

Key words: frailty; incidence density; nested case-control study; influencing factors