中国老年人内在能力与日常生活活动的相关性：基于CHARLS数据

doi:10.3969/j.issn.1006-9771.2023.10.004

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (10): 1140-1146.doi: 10.3969/j.issn.1006-9771.2023.10.004

中国老年人内在能力与日常生活活动的相关性：基于CHARLS数据

刘梦雅, 张利(), 张梦, 宋楠楠, 周静蕾

蚌埠医学院护理学院，安徽蚌埠市 233000

收稿日期:2023-06-08 修回日期:2023-06-26 出版日期:2023-10-25 发布日期:2023-11-16
通讯作者: 张利(1971-)，女，硕士，副教授。E-mail： 390026566@qq.com
作者简介:刘梦雅(1997-)，女，汉族，江苏淮安市人，硕士研究生，主要研究方向：社区护理、老年护理、健康教育。
基金资助:
安徽高校人文社会科学研究重点项目(SK2021A0443);安徽高校人文社会科学研究重点项目(SK2018A0178);蚌埠医学院研究生科研创新计划立项项目(Byycx23016)

Correlation between intrinsic capacity and activities of daily living for old adults in China: based on China Health and Retirement Longitudinal Study

LIU Mengya, ZHANG Li(), ZHANG Meng, SONG Nannan, ZHOU Jinglei

School of Nursing, Bengbu Medical College, Bengbu, Anhui 233000, China

Received:2023-06-08 Revised:2023-06-26 Published:2023-10-25 Online:2023-11-16
Contact: ZHANG Li, E-mail: 390026566@qq.com
Supported by:
Anhui University Humanities and Social Science Research Key Project(SK2021A0443);Anhui University Humanities and Social Science Research Key Project(SK2018A0178);Bengbu Medical College Graduate Research and Innovation Program(Byycx23016)

摘要/Abstract

摘要：

目的探讨老年人内在能力各维度权重和综合指数，检验内在能力与老年人日常生活活动(ADL)受限的相关性。
方法采用2015年中国健康与养老追踪(CHARLS)调查中5 506例≥ 60岁老年人的调查数据中关于内在能力和ADL的评估资料。内在能力评估包括认知、运动、活力、感觉和心理，ADL包括穿衣、洗澡、吃饭、上床或下床、如厕以及控制大小便6项。
结果共有1 343例老年人存在ADL受限(24.4%)，其中女性、受教育水平低、年龄大、丧偶、慢性疾病数量多，自评健康较差的老年人，易发生ADL受限。主成分分析显示，心理维度权重最大，其次是认知维度，运动维度权重最低。在控制年龄、性别、居住环境、经济收入、受教育水平、婚姻、吸烟饮酒、慢性疾病数量以及自评健康等混杂因素后，Logistic回归分析显示，运动能力下降(OR = 0.581, 95%CI 0.501~0.674)、抑郁(OR = 0.426, 95%CI 0.368~0.493)、视听力受损(OR = 0.813, 95%CI 0.699~0.947; OR = 0.684, 95%CI 0.578~0.809)、超重(OR = 1.203, 95%CI 1.014~1.428)和肥胖(OR = 1.584, 95%CI 1.312~1.912)是老年人ADL受限的独立危险因素。
结论内在能力下降是老年人ADL受限的预测因子。

关键词: 老年人, 内在能力, 日常生活活动

Abstract:

Objective To explore the weights and comprehensive indices of each field of intrinsic capacity of old adults, and the correlation between intrinsic capacity and activities of daily living (ADL).
Methods The data of 5 506 cases aged more than 60 years in the 2015 China Health and Retirement Longitudinal Study (CHARLS) were used to collect the assessment of intrinsic capacity and the measurement of ADL. The assessment of intrinsic capacity included cognition, motor, vitality, sensory and psychology; while the ADL scale included six indicators, namely dressing, bathing, eating, getting in or out of bed, going to the toilet, and controlling urine and feces.
Results A total of 1 343 cases were limited in ADL (24.4%). Women, lower education level, older age, the widowed, greater number of chronic diseases, and poorer self-rated health were the factors more likely to be limited in ADL. Principal component analysis showed that the largest weight value was in psychological domain, followed by the cognitive domain, and the lowest weight value was in the motor domain. After controlling for the effects of age, gender, living environment, economic income, education level, marriage, smoking and drinking, number of chronic diseases, and self-rated health, the Logistic regression analysis showed that low exercise capacity (OR = 0.581, 95%CI 0.501 to 0.674), depression (OR = 0.426, 95%CI 0.368 to 0.493), audile and visual impairment (OR = 0.813, 95%CI 0.699 to 0.947; OR = 0.684, 95%CI 0.578 to 0.809), overweight (OR = 1.203, 95%CI 1.014 to 1.428) and obesity (OR = 1.584, 95%CI 1.312 to 1.912) were independent risk factors for ADL limitation in older adults.
Conclusion Decrease of intrinsic capacity is a predictor for ADL limitation in older adults.

Key words: older adult, intrinsic capacity, activities of daily living

中图分类号:

R493

刘梦雅, 张利, 张梦, 宋楠楠, 周静蕾. 中国老年人内在能力与日常生活活动的相关性：基于CHARLS数据[J]. 《中国康复理论与实践》, 2023, 29(10): 1140-1146.

LIU Mengya, ZHANG Li, ZHANG Meng, SONG Nannan, ZHOU Jinglei. Correlation between intrinsic capacity and activities of daily living for old adults in China: based on China Health and Retirement Longitudinal Study[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1140-1146.

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项目	控制变量	变量编码信息解释
社会人口统计学变量	年龄	1 = 60~69岁;2 = 70~79岁;3 = 80岁及以上
	性别	1 = 女性;0 = 男性
	婚姻状况	1 = 已婚;2 = 未婚;3 = 丧偶;4 = 离异、分居
	受教育水平	1 = 文盲;2 = 小学;3 = 中学(包括中专);4 = 大学及以上学历(包括大专)
	居住地	1 = 城市;2 = 农村
	吸烟	1 = 不吸烟(包括戒烟);2 = 吸烟
	饮酒	1 = 不饮酒(包括戒酒);2 = 饮酒
	经济收入	1 = 年收入< 15 000元;2 = 年收入15 000~ < 30 000元;3 = 年收入≥ 30 000元
健康状况	自评健康	1 = 不好;2 = 一般;3 = 好;4 = 极好
医学协变量	慢性疾病数量	1 = 0个;2 = 1个;3 = ≥ 2个

社会人口学特征	分类	ADL 受限	χ²值	P值	社会人口学特征	分类	ADL 受限	χ²值	P值
年龄	60~69岁	781	25.301	< 0.001	经济收入	< 15 000元/年	1184	0.589	0.745
	70~79岁	450	19.178	< 0.001		15 000~ < 30 000元/年	106	0.386	0.535
	≥ 80岁	112	11.957	0.001		≥ 30 000元/年	53	0.167	0.683
性别	男	546	12.864	< 0.001	吸烟	不吸烟	1030	1.051	0.305
	女	797				吸烟	313
受教育水平	文盲	525	28.417	< 0.001	饮酒	不饮酒	969	0.236	0.627
	小学	616	12.948	< 0.001		饮酒	374
	中学	193	25.362	< 0.001	慢性疾病数	0个	685	18.015	< 0.001
	大学及以上	9	4.437	0.035		1个	398	8.001	0.005
婚姻状况	已婚	1011	5.190	0.158		≥ 2个	260	14.969	< 0.001
	未婚	14	0.452	0.501	自评健康	极好	48	392.877	< 0.001
	丧偶	308	4.841	0.028		好	69
	离异、分居	10	0.012	0.911		一般	524
居住环境	城市	572	1.211	0.271		不好	702
	农村	771

成分	初始特征值			旋转载荷平方和
成分	特征值	方差/%	累积/%	总计	方差/%	累积/%
1	1.993	33.211	33.211	1.566	26.092	26.092
2	1.138	18.966	52.177	1.492	24.875	50.967
3	1.081	18.010	70.187	1.153	19.220	70.187
4	0.661	11.024	81.212
5	0.583	9.713	90.925
6	0.545	9.075	100.000

维度	因子1	因子2	因子3
认知	0.800	0.068	0.254
运动	0.776	0.026	-0.402
心理	0.554	0.467	0.257
视力	0.102	0.797	-0.099
听力	0.041	0.796	0.052
活力	0.067	-0.017	0.921

内在能力	单因素		多因素
内在能力	OR值(95%CI)	P值	OR值(95%CI)	P值
运动	0.488(0.426~0.560)	< 0.001	0.581(0.501~0.674)	< 0.001
认知	0.723(0.567~0.922)	0.009	0.780(0.607~1.003)	0.053
心理	0.327(0.285~0.376)	< 0.001	0.426(0.368~0.493)	< 0.001
视力	0.696(0.601~0.807)	< 0.001	0.813(0.699~0.947)	0.008
听力	0.616(0.523~0.725)	< 0.001	0.684(0.578~0.809)	< 0.001
活力
偏瘦	1.100(0.862~1.404)	0.442	1.019(0.795~1.307)	0.880
超重	1.183(1.003~1.395)	0.045	1.203(1.014~1.428)	0.034
肥胖	1.583(1.321~1.896)	< 0.001	1.584(1.312~1.912)	< 0.001

中国老年人内在能力与日常生活活动的相关性：基于CHARLS数据

Correlation between intrinsic capacity and activities of daily living for old adults in China: based on China Health and Retirement Longitudinal Study

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维度	权重
心理	0.2326
认知	0.1894
视力	0.1675
听力	0.1823
活力	0.1606
运动	0.0676

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