正/负性情绪对中国老年人死亡风险影响的前瞻性队列研究

doi:10.19723/j.issn.1671-167X.2022.02.009

摘要/Abstract

摘要：

目的: 探索正/负性情绪对中国老年人死亡风险的影响。方法: 利用中国老年健康影响因素跟踪调查2008、2011、2014和2018年4期的数据,以2008年65周岁及以上的10 993例老年人为研究对象,比较不同性别和年龄组老年人的各维度正/负性情绪状况及差异,通过构建Cox比例风险模型分析正/负性情绪对其死亡风险的影响。结果: 与女性老年人相比,男性老年人负性情绪较低,正性情绪较高。随着年龄增加,老年人的负性情绪增加,而正性情绪减少。调整了基线调查时受访者的基本人口特征、健康状况和生活习惯变量后,分析结果显示正性情绪维度下,“整洁偏好”(HR=0.922,95%CI:0.889~0.956)、“自主性”(HR=0.933,95%CI:0.914~0.952)和“年轻感”(HR=0.948,95%CI:0.927~0.969)对老年人的死亡风险起到保护作用,而在“豁达观”这一维度,不同回答老年人其死亡风险差异无统计学意义。负性情绪维度下,“紧张与恐惧”(HR=1.039,95%CI:1.014~1.065)、“孤独感”(HR=1.053,95%CI:1.029~1.079)和“无用感”(HR=1.069,95%CI:1.047~1.091)对老年人的死亡风险起到危害作用。正性情绪越多,老年人的死亡风险越低(HR=0.967,95%CI:0.956~0.978),而负性情绪越多,老年人死亡风险则越高(HR=1.024,95%CI:1.013~1.035)。结论: 老年人各维度的负性情绪可能增加其死亡风险,应及时疏导老年人的负性情绪;在老年人的健康促进中也应注重对其各维度正性情绪的鼓励,这需要家庭、社区和政府的共同努力。

关键词: 正性情绪, 负性情绪, 老年人, 死亡风险, 前瞻性队列

Abstract:

Objective: To explore the influence of positive/negative effectivity on the mortality risk of the Chinese elderly. Methods: Using the latest four surveys data of Chinese longitudinal healthy longevity survey in 2008, 2012, and 2014, as well as 2018 and selecting 10 993 elderly people who were aged 65 and above as research objects, this paper compared the positive/negative effectivity status and differences of the elderly in different gender and age groups. And then this paper analyzed the effect of positive/negative effectivity on elderly people’s mortality risk by constructing Cox proportional hazards model. Results: Compared with the female elderly, the male elderly had lower negative effectivity and higher positive effectivity. With the increase of age, the negative effectivity of the elderly increased, while the positive effectivity decreased. The results showed that after adjusting for the basic demographic characteristics, health status and living habits of the respondents in the baseline survey, in the positive effectivity dimension, “clean preference” (HR=0.922, 95%CI:0.889-0.956), “autonomy” (HR=0.933, 95%CI: 0.914-0.952) and “sense of youth” (HR=0.948, 95%CI:0.927-0.969), had a protective effect on the mortality risk of the elderly, while in the dimension of “open-minded view”, there was no significant difference in the mortality risk of the elderly with different answers. In the negative effecti-vity dimension, “tension and fear” (HR=1.039, 95%CI: 1.014-1.065), “loneliness” (HR=1.053, 95%CI:1.029-1.079) and “uselessness” had a harmful effect on the mortality risk of the elderly. The more positive effectivity, the lower the mortality risk of the elderly (HR=0.967, 95%CI: 0.956-0.978), while the more negative effectivity, the higher the mortality risk of the elderly (HR=1.024, 95%CI:1.013-1.035). Conclusion: The negative effectivity of the elderly in all dimensions may increase the mortality risk of elderly people. We ought to dredge the negative emotions of the elderly in time. In the health promotion of the elderly, we should also pay attention to the encouragement of positive effectivity in all dimensions, which requires the joint efforts of families, communities and governments.

Key words: Positive affectivity, Negative affectivity, Elderly, Mortality risk, Prospective cohort study

中图分类号:

R592

刘杰,郭超. 正/负性情绪对中国老年人死亡风险影响的前瞻性队列研究[J]. 北京大学学报（医学版）, 2022, 54(2): 255-260.

LIU Jie,GUO Chao. A prospective cohort study of the influence of positive/negative effectivity on the mortality risk of the Chinese elderly[J]. Journal of Peking University (Health Sciences), 2022, 54(2): 255-260.

图/表 2

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表2

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Items	Value
Female, n(%)	5 894 (53.62)
Age/years, $x -$ ±s	84.84±10.74
Han nationalty, n(%)	10 237 (93.12)
Rural residents, n(%)	6 862 (62.42)
Education/years, $x -$ ±s	2.20±3.48
Logarithm of household income, n(%)	9.21 (1.47)
Marital status, n(%)
Married/partnered	7 059 (64.21)
Others	3 934(35.79)
Live with family, n(%)	9 019 (82.04)
Have a pension, n(%)	1 983 (18.04)
Self-rated health state, n(%)	5 560 (50.58)
Self-maintenance, n(%)	1 459 (13.27)
Suffering from chronic diseases, n(%)	5 162 (46.96)
Satisfied with life, n(%)	4 417 (40.18)
Smoke, n(%)	8 870 (80.69)
Drink, n(%)	8 918 (81.12)
Exercise, n(%)	7 617 (69.29)

Items	Total	Gender
Items	Total	Male	Female		P value	65-74		75-84		85-94	95-104		P value
Score of positive effectivity, $x -$ ±s
Open-minded	3.86±0.70	3.91±0.67		3.81±0.72			<0.001		3.90±0.71			3.84±0.70		3.82±0.70	3.87±0.69	<0.001
Clean preference	3.82±0.67	3.74±0.68		3.88±0.65			<0.001		3.88±0.66			3.83±0.65		3.79±0.68	3.79±0.67	<0.001
Autonomy	3.65±1.20	3.84±1.17		3.48±1.21			<0.001		4.08±1.04			3.80±1.15		3.50±1.22	3.22±1.23	<0.001
Sense of youth	2.76±1.11	2.80±1.10		2.71±1.11			<0.001		2.88±1.07			2.78±1.10		2.74±1.12	2.62±1.11	<0.001
Score of negative effectivity, $x -$ ±s
Tension and fear	1.98±0.97	1.86±0.93		2.08±0.99			<0.001		1.86±0.92			1.95±0.96		2.05±1.00	2.02±0.96	<0.001
Loneliness	2.04±1.02	1.94±0.99		2.13±1.04			<0.001		1.78±0.94			1.99±1.01		2.15±1.04	2.21±1.04	<0.001
Uselessness	2.78±1.18	2.66±1.18		2.89±1.17			<0.001		2.54±1.16			2.75±1.16		2.88±1.18	2.94±1.17	<0.001
Total score of positive effectivity, $x -$ ±s	14.08±2.37	14.30±2.33		13.87±2.37			<0.001		14.75±2.19			14.26±2.28		13.85±2.40	13.50±2.39	<0.001
Total score of negative effectivity, $x -$ ±s	6.80±2.42	6.46±2.35		7.09±2.44			<0.001		6.18±2.26			6.68±2.40		7.08±2.47	7.16±2.40	<0.001