Email Alert | RSS

北京大学学报（医学版） ›› 2024, Vol. 56 ›› Issue (3): 431-440. doi: 10.19723/j.issn.1671-167X.2024.03.009

• 论著 • 上一篇    下一篇

基于不同失能水平的老年人照料需求的影响因素

张浩宇1,石逸雯2,潘薇1,刘爱萍1,3,孙昕霙1,3,李曼4,张旭熙1,3,*()   

  1. 1. 北京大学公共卫生学院社会医学与健康教育系，北京 100191
    2. 北京大学第五临床医学院，北京 100005
    3. 北京大学医学部老年健康研究中心，北京 100191
    4. 苏州大学社会学院，江苏苏州 215006
  • 收稿日期:2024-02-04 出版日期:2024-06-18 发布日期:2024-06-12
  • 通讯作者: 张旭熙 E-mail:xuxizhang@bjmu.edu.cn
  • 基金资助:
    国家自然科学基金(72204008);国家自然科学基金(72104004);北京大学引进人才计划与启动项目(BMU2023YJ012)

Factors associated with the care needs of the older adults based on different disability levels

Haoyu ZHANG1,Yiwen SHI2,Wei PAN1,Aiping LIU1,3,Xinying SUN1,3,Man LI4,Xuxi ZHANG1,3,*()   

  1. 1. Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
    2. Peking University Fifth School of Clinical Medicine, Beijing 100005, China
    3. Center for Healthy Aging, Peking University Health Science Center, Beijing 100191, China
    4. School of Society, Soochow University, Suzhou 215006, Jiangsu, China
  • Received:2024-02-04 Online:2024-06-18 Published:2024-06-12
  • Contact: Xuxi ZHANG E-mail:xuxizhang@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundation of China(72204008);the National Natural Science Foundation of China(72104004);the Scientific Research Foundation for Talent Introduction Plan of Peking University(BMU2023YJ012)

RICH HTML

   

PDF (PC)

摘要：

目的: 对65~105岁老年人以年龄进行分层，探究照料需求的影响因素特点。方法: 共纳入12 244名2018年中国老年健康影响因素跟踪调查(Chinese longitudinal healthy longevity survey，CLHLS)横断面数据中的老年人，分为低龄(65~79岁)、中龄(80~89岁)、高龄(90~105岁)三组。利用综合失能指数(disability index，DI)从四个维度评估老年人的失能水平，反映其照料需求，采用无序多分类Logistic回归进行影响因素分析。结果: 12 244名老年人中，中、高照料需求的老年人占比达43.4%。老年人照料需求高的影响因素包括年龄更大、患慢性病数量更多、无锻炼习惯、睡眠时间过长(≥9 h/d)、有抑郁倾向、与子女同住、空巢合居、未受过教育(P < 0.05)。此外，低龄组老年人还有吸烟史(OR=2.009，95% CI：1.019~3.959)、饮酒史(OR=2.213，95% CI：1.141~4.291)和自评贫穷(OR=2.051，95% CI：1.189~3.540)；中龄组老年人还有女性(OR=1.373，95% CI：1.038~1.817)、从不饮酒(OR=1.551，95% CI：1.059~2.269)和无医疗保险(OR=1.598，95% CI：1.053~2.426)；高龄组老年人还有女性(中照料需求vs.低照料需求：OR=1.412，95% CI：1.062~1.878；高照料需求vs.低照料需求：OR=1.506，95% CI：1.137~1.993)、自评贫穷(OR=2.064，95% CI：1.282~ 3.323)和无医疗保险(OR=1.621，95% CI：1.148~2.291)。结论: 各年龄组老年人照料需求的共性影响因素包括年龄、慢性病、锻炼、睡眠、抑郁倾向、居住方式和受教育情况，低龄组的特有因素包括吸烟、饮酒和经济水平，中、高龄组的特有因素包括性别和医疗保险。建议针对上述影响因素开展前瞻性队列研究和重点人群的干预研究，为政策制定提供可靠依据。

关键词: 照料需求, 失能, 老年人, 医疗服务需求

Abstract:

Objective: To identify the factors associated with the care needs of the older adults aged 65-105 by age groups, and to compare these factors across different age groups. Methods: A total of 12 244 older adults from the Chinese longitudinal healthy longevity survey (CLHLS) conducted in 2018 were included in the analyses. The participants were categorized into three age groups: young-old (aged 65-79), middle-old (aged 80-89), and oldest-old (aged 90-105). The level of disability was measured by the disability index (DI) in four dimensions, reflecting their care needs. Potential factors associated with care needs were selected based on the health ecological model (HEM), including perspectives of personal characteristics, behavioral characteristics, interpersonal network, living and working conditions, and policy environment. Multifactor analysis was performed using multinomial Logistic regression. Results: Among China ' s 12 244 older adults, 43.4% had medium or high care needs. Factors for higher care needs of older adults included higher age, higher number of chronic diseases, no exercise habit, excessive sleep duration (≥9 h/d), depressive tendency, living with children or spouse, and uneducated (all P < 0.05). In addition, the young-old group who were past smokers (OR=2.009, 95% CI: 1.019-3.959), were past drinkers (OR=2.213, 95% CI: 1.141-4.291), and reported self-perceived poverty (OR=2.051, 95% CI: 1.189-3.540), had higher level of care needs. The middle-old group who were female (OR=1.373, 95% CI: 1.038-1.817), never drank alcohol (OR=1.551, 95% CI: 1.059-2.269), and were lack of medical insurance (OR=1.598, 95% CI: 1.053-2.426), and had higher level of care needs. The oldest-old group who were female (medium care needs vs. low care needs: OR=1.412, 95% CI: 1.062-1.878; high care needs vs. low care needs: OR=1.506, 95% CI: 1.137-1.993), reported self-perceived poverty (OR=2.064, 95% CI: 1.282-3.323), and were lack of medical insurance (OR=1.621, 95% CI: 1.148-2.291), and had higher level of care needs. Conclusion: The identical factors associated with care needs across different age groups include age, chronic disease, exercise, sleep, depression, living arrangement, and education. Smoking, alcohol consumption, and economic status are specific factors among the young-old group of the older adults, while gender and medical insurance are specific factors among the middle-old and the oldest-old group of the older adults. We recommend conducting prospective cohort studies and intervention studies among specific age groups on the above factors to provide reliable evidence for policy formulation.

Key words: Care needs, Disability, Aged, Health services needs and demand

中图分类号: 

  • R161.7

表1

研究对象的基本情况"

Characteristics Totala(n=12 244) Age group Statistical valuec P valuec
65-79 years (n=4 578) 80-89 years (n=3 238) 90-105 years (n=4 428)
Personal characteristicsb
Gender, n (%) 154.886 < 0.001
  Male 5 569 (45.5) 2 321 (50.7) 1 558 (48.1) 1 690 (38.2)
  Female 6 675 (54.5) 2 257 (49.3) 1 680 (51.9) 2 738 (61.8)
Age/years, ${\bar x}$±s 84.30±11.18 72.42±4.31 84.13±2.84 96.72±4.54
Ethnic group, n (%) 0.544 0.762
  Han ethnic group 10 002 (94.1) 3 772 (94.0) 2 474 (94.1) 3 756 (94.3)
  National minority 623 (5.9) 242 (6.0) 156 (5.9) 225 (5.7)
Number of chronic diseases, ${\bar x}$±s 1.59±1.43 1.46±1.43 1.67±1.52 1.66±1.35 14.791 < 0.001
Behavioral characteristicsb
Smoking, n (%) 148.183 < 0.001
  Never 8 325 (69.0) 2 915 (64.7) 2 158 (67.6) 3 252 (74.4)
  Past smoker 1 818 (15.1) 676 (15.0) 524 (16.4) 618 (14.1)
  Current smoker 1 928 (16.0) 917 (20.3) 511 (16.0) 500 (11.4)
Drinking, n (%) 121.913 < 0.001
  Never 8 803 (73.2) 3 092 (68.7) 2 338 (73.6) 3 373 (77.6)
  Past drinker 1 411 (11.7) 540 (12.0) 398 (12.5) 473 (10.9)
  Current drinker 1 809 (15.0) 868 (19.3) 442 (13.9) 499 (11.5)
Exercise, n (%) 623.536 < 0.001
  No 8 212 (68.0) 2 568 (56.7) 2 101 (65.7) 3 543 (81.2)
  Yes 3 873 (32.0) 1 960 (43.3) 1 095 (34.3) 818 (18.8)
Sleep duration, n (%) 420.634 < 0.001
  Short (< 6 h) 4 373 (36.9) 1 747 (38.5) 1 271 (40.1) 1 355 (32.8)
  Moderate (6-9 h) 4 329 (36.6) 1 955 (43.1) 1 126 (35.5) 1 248 (30.2)
  Long (≥9 h) 3 136 (26.5) 834 (18.4) 773 (24.4) 1 529 (37.0)
Depression, n (%) 57.923 < 0.001
  No depressive tendency 4 836 (43.9) 2 173 (48.2) 1 242 (40.4) 1 421 (41.5)
  Depressive tendency 6 173 (56.1) 2 333 (51.8) 1 833 (59.6) 2 007 (58.5)
Interpersonal networkb
Living arrangements, n (%) 2 073.006 < 0.001
  Living with children 5 971 (48.8) 1 606 (35.1) 1 398 (43.2) 2 967 (67.0)
  Living with spouse 3 578 (29.2) 2 239 (48.9) 971 (30.0) 368 (8.3)
  Living with others 641 (5.2) 133 (2.9) 113 (3.5) 395 (8.9)
  Living alone 2 054 (16.8) 600 (13.1) 756 (23.3) 698 (15.8)
Type of account, n (%) 0.539 0.764
  Urban 6 677 (54.5) 2 516 (55.0) 1 759 (54.3) 2 402 (54.2)
  Rural 5 567 (45.5) 2 062 (45.0) 1 479 (45.7) 2 026 (45.8)
Area, n (%) 11.780 0.067
  Eastern area 5 436 (44.4) 2 075 (45.3) 1 438 (44.4) 1 923 (43.4)
  Middle area 3 225 (26.3) 1 201 (26.2) 873 (27.0) 1 151 (26.0)
  Western area 3 074 (25.1) 1 111 (24.3) 780 (24.1) 1 183 (26.7)
  Northeastern area 509 (4.2) 191 (4.2) 147 (4.5) 171 (3.9)
Living and working conditionsb
Education, n (%) 1 574.230 < 0.001
  0 year 5 016 (47.6) 1 009 (25.3) 1 318 (51.1) 2 689 (67.9)
  1-6 years 3 513 (33.4) 1 715 (43.0) 867 (33.6) 931 (23.5)
  Over 6 years 2 004 (19.0) 1 267 (31.7) 394 (15.3) 343 (8.7)
Retirement security, n (%) 105.410 < 0.001
  Yes 3 167 (26.7) 1 353 (30.5) 902 (28.8) 912 (21.2)
  No 8 703 (73.3) 3 090 (69.5) 2 226 (71.2) 3 387 (78.8)
Economic status, n (%) 4.268 0.371
  Rich 2 371 (19.5) 857 (18.8) 630 (19.6) 884 (20.2)
  Moderate 8 504 (70.0) 3 226 (70.9) 2 229 (69.4) 3 049 (69.6)
  Poor 1 269 (10.4) 469 (10.3) 354 (11.0) 446 (10.2)
Policy environmentb
Old-age insurance, n (%) 67.264 < 0.001
  No 5 853 (50.5) 2 021 (46.4) 1 529 (49.8) 2 303 (55.3)
  Yes 5 737 (49.5) 2 333 (53.6) 1 539 (50.2) 1 865 (44.7)
Medical insurance, n (%) 32.616 < 0.001
  No 1 347 (11.3) 443 (10.0) 322 (10.2) 582 (13.5)
  Yes 10 569 (88.7) 4 008 (90.0) 2 832 (89.8) 3 729 (86.5)
Disability index score & Care needs
Disability index score, ${\bar x}$±s 19.53±23.24 4.64±9.53 15.23±17.61 38.08±24.20 18.603 < 0.001
Low care needsd, n (%) 6 925 (56.6) 4 097 (89.5) 1 945 (60.1) 883 (19.9) 5 067.526 < 0.001
Middle care needsd, n (%) 2 029 (16.6) 340 (7.4) 746 (23.0) 943 (21.3)
High care needsd, n (%) 3 290 (26.9) 141 (3.1) 547 (16.9) 2 602 (58.8)

表2

分年龄组不同照料需求老年人的特征比较"

Characteristics 65-79 years (n=4 578) 80-89 years (n=3 238) 90-105 years (n=4 428)
Low care needsa (n=4 097) Medium care needsa (n=340) High care needsa (n=141) Statistical valueb Low care needsa (n=1 945) Medium care needsa (n=746) High care needsa (n=547) Statistical valueb Low care needsa (n=883) Medium care needsa (n=943) High care needsa (n=2602) Statistical valueb
Personal characteristicsc
Gender，n (%) 27.177 *** 89.200 *** 217.005 ***
  Ma1e 2 131 (52.0) 132 (38.8) 58 (41.1) 1 067 (54.9) 277 (37.1) 214 (39.1) 508 (57.5) 397 (42.1) 785 (30.2)
  Fema1e 1 966 (48.0) 208 (61.2) 83 (58.9) 878 (45.1) 469 (62.9) 333 (60.9) 375 (42.5) 546 (57.9) 1 817 (69.8)
Age/years，${\bar x}$±s 72.15±4.27 74.49±4.06 75.39±3.75 83.315 *** 83.59±2.72 84.60±2.80 85.38±2.86 103.752 *** 93.98±3.95 95.56±4.40 98.06±4.24 353.708 ***
Ethnic group，n (%) 0.190 3.922 3.807
  Han ethnic group 3 388 (94.0) 269 (93.4) 115 (94.3) 1 481 (94.8) 582 (93.6) 411 (92.4) 714 (93.1) 795 (94.0) 2 247 (94.9)
  Nationa1 minority 216 (6.0) 19 (6.6) 7 (5.7) 82 (5.2) 40 (6.4) 34 (7.6) 53 (6.9) 51 (6.0) 121 (5.1)
Number of chronic diseases，${\bar x}$±s 1.39±1.40 1.83±1.59 2.31±1.71 41.094 *** 1.44±1.43 1.85±1.57 2.27±1.58 72.607 *** 1.17±1.25 1.46±1.37 1.89±1.32 112.237 ***
Behavioral characteristicsc
Smoking，n (%) 27.022 *** 41.327 *** 58.949 ***
  Never 2 585 (64.1) 234 (69.6) 96 (68.6) 1 213 (63.5) 552 (74.5) 393 (72.6) 592 (67.7) 648 (69.9) 2 012 (78.3)
  Past smoker 590 (14.6) 53 (15.8) 33 (23.6) 347 (18.2) 90 (12.1) 87 (16.1) 144 (16.5) 143 (15.4) 331 (12.9)
  Current smoker 857 (21.3) 49 (14.6) 11 (7.9) 351 (18.4) 99 (13.4) 61 (11.3) 138 (15.8) 136 (14.7) 226 (8.8)
Drinking，n (%) 30.955 *** 47.651 *** 60.743 ***
  Never 2 736 (67.9) 251 (75.6) 105 (76.1) 1 328 (69.5) 585 (80.4) 425 (79.0) 634 (72.9) 671 (72.3) 2 068 (81.2)
  Past drinker 476 (11.8) 39 (11.7) 25 (18.1) 261 (13.7) 73 (10.0) 64 (11.9) 97 (11.1) 113 (12.2) 263 (10.3)
  Current drinker 818 (20.3) 42 (12.7) 8 (5.8) 323 (16.9) 70 (9.6) 49 (9.1) 139 (16.0) 144 (15.5) 216 (8.5)
Exercise，n (%) 48.260 *** 167.146 *** 312.014 ***
  No 2 231 (55.0) 228 (67.9) 109 (78.4) 1 103 (57.3) 545 (74.3) 453 (84.4) 554 (64.3) 688 (74.0) 2 301 (89.6)
  Yes 1 822 (45.0) 108 (32.1) 30 (21.6) 822 (42.7) 189 (25.7) 84 (15.6) 308 (35.7) 242 (26.0) 268 (10.4)
S1eep duration，n (%) 38.468 *** 46.293 *** 53.933 ***
  Short(< 6 h) 1 540 (37.8) 147 (44.4) 60 (44.8) 719 (37.4) 333 (45.4) 219 (42.6) 297 (33.8) 300 (32.3) 758 (32.6)
  Moderate(6-9 h) 1 812 (44.5) 109 (32.9) 34 (25.4) 766 (39.9) 222 (30.2) 138 (26.8) 321 (36.5) 316 (34.1) 611 (26.3)
  Long(≥9 h) 719 (17.7) 75 (22.7) 40 (29.9) 437 (22.7) 179 (24.4) 157 (30.5) 262 (29.8) 312 (33.6) 955 (41.1)
Depression，n (%) 83.078 *** 71.157 *** 39.087 ***
  No depressive tendency 2 047 (50.4) 99 (30.5) 27 (22.0) 883 (46.0) 240 (33.3) 119 (27.3) 424 (49.3) 381 (43.1) 616 (36.6)
  Depressive tendency 2 011 (49.6) 226 (69.5) 96 (78.0) 1 036 (54.0) 480 (66.7) 317 (72.7) 436 (50.7) 504 (56.9) 1 067 (63.4)
Interpersonal networkc
Living arrangements，n (%) 16.387 * 71.741 *** 248.282 ***
  Living with children 1 422 (34.7) 120 (35.3) 64 (45.4) 760 (39.1) 340 (45.6) 298 (54.5) 489 (55.4) 575 (61.0) 1 903 (73.1)
  Living with spouse 2 028 (49.5) 151 (44.4) 60 (42.6) 653 (33.6) 187 (25.1) 131 (23.9) 146 (16.5) 79 (8.4) 143 (5.5)
  Living with others 120 (2.9) 8 (2.4) 5 (3.5) 61 (3.1) 21 (2.8) 31 (5.7) 43 (4.9) 82 (8.7) 270 (10.4)
  Living alone 527 (12.9) 61 (17.9) 12 (8.5) 471 (24.2) 198 (26.5) 87 (15.9) 205 (23.2) 207 (22.0) 286 (11.0)
Type of account，n (%) 1.490 4.493 1.199
  Urban 2 262 (55.2) 183 (53.8) 71 (50.4) 1 086 (55.8) 389 (52.1) 284 (51.9) 485 (54.9) 523 (55.5) 1 394 (53.6)
  Rura1 1 835 (44.8) 157 (46.2) 70 (49.6) 859 (44.2) 357 (47.9) 263 (48.1) 398 (45.1) 420 (44.5) 1 208 (46.4)
Area，n (%) 9.674 8.342 40.106 ***
  Eastern area 1 877 (45.8) 147 (43.2) 51 (36.2) 889 (45.7) 319 (42.8) 230 (42.0) 332 (37.6) 418 (44.3) 1 173 (45.1)
  Middle area 1 055 (25.8) 99 (29.1) 47 (33.3) 498 (25.6) 210 (28.2) 165 (30.2) 225 (25.5) 226 (24.0) 700 (26.9)
  Western area 994 (24.3) 83 (24.4) 34 (24.1) 478 (24.6) 177 (23.7) 125 (22.9) 297 (33.6) 269 (28.5) 617 (23.7)
  Northeastern area 171 (4.2) 11 (3.2) 9 (6.4) 80 (4.1) 40 (5.4) 27 (4.9) 29 (3.3) 30 (3.2) 112 (4.3)
Living and working conditionsc
Education，n (%) 152.443 *** 125.298 *** 207.037 ***
  0 year 808 (22.5) 139 (48.9) 62 (53.0) 653 (42.2) 384 (63.8) 281 (65.7) 375 (49.0) 524 (62.5) 1 790 (75.9)
  1-6 years 1 580 (44.0) 97 (34.2) 38 (32.5) 614 (39.6) 155 (25.7) 98 (22.9) 284 (37.1) 233 (27.8) 414 (17.6)
  Over 6 years 1 202 (33.5) 48 (16.9) 17 (14.5) 282 (18.2) 63 (10.5) 49 (11.4) 107 (14.0) 82 (9.8) 154 (6.5)
Retirement security，n (%) 15.339 *** 24.974 *** 27.536 ***
  Yes 1 248 (31.4) 76 (23.1) 29 (21.3) 607 (32.1) 166 (23.2) 129 (24.8) 225 (26.1) 222 (24.0) 465 (18.5)
  No 2 730 (68.6) 253 (76.9) 107 (78.7) 1 285 (67.9) 550 (76.8) 391 (75.2) 638 (73.9) 702 (76.0) 2 047 (81.5)
Economic status，n (%) 65.108 *** 49.934 *** 47.116 ***
  Rich 803 (19.7) 35 (10.4) 19 (13.6) 444 (22.9) 110 (14.9) 76 (14.1) 222 (25.3) 219 (23.4) 443 (17.3)
  Moderate 2 896 (71.1) 241 (71.3) 89 (63.6) 1 320 (68.2) 530 (71.7) 379 (70.4) 594 (67.8) 634 (67.8) 1 821 (70.9)
  Poor 375 (9.2) 62 (18.3) 32 (22.9) 172 (8.9) 99 (13.4) 83 (15.4) 60 (6.8) 82 (8.8) 304 (11.8)
Policy environmentc
Old-age insurance，n (%) 1.497 1.507 9.023 *
  No 1 800 (46.1) 153 (48.4) 68 (50.4) 906 (49.0) 362 (51.6) 261 (50.6) 435 (52.5) 469 (52.5) 1 399 (57.2)
  Yes 2 103 (53.9) 163 (51.6) 67 (49.6) 944 (51.0) 340 (48.4) 255 (49.4) 394 (47.5) 424 (47.5) 1 047 (42.8)
Medical insurance, n (%) 3.065 8.856 * 17.389 * * *
  No 387 (9.7) 41 (12.6) 15 (11.1) 186 (9.8) 63 (8.7) 73 (13.6) 91 (10.6) 103 (11.2) 388 (15.3)
  Yes 3 604 (90.3) 284 (87.4) 120 (88.9) 1705 (90.2) 663 (91.3) 464 (86.4) 765 (89.4) 818 (88.8) 2 146 (84.7)

表3

不同年龄组老年人照料需求影响因素的无序多分类Logistic回归分析"

Factors 65-79 years(ref = low care needs) 80-89 years(ref = low care needs) 90-105 years(ref = low care needs)
Medium care needsa OR value (95% CI)b High care needsa OR value (95% CI)b Medium care needsa OR value (95% CI)b High care needsa OR value (95% CI)b Medium care needsa OR value (95% CI)b High care needsa OR value (95% CI)b
Personal characteristicsc
Gender (ref = male)
  Fema1e 1.165 (0.789-1.719) 1.173 (0.627-2.196) 1.373 (1.038-1.817) * 1.241 (0.865-1.781) 1.412 (1.062-1.878) * 1.506 (1.137-1.993) **
Age(continuous variab1e) 1.112 (1.075-1.150) *** 1.214 (1.142-1.290) *** 1.134 (1.090-1.180) *** 1.252 (1.190-1.318) *** 1.102 (1.072-1.133) *** 1.229 (1.196-1.264) ***
Number of chronic diseases 1.202(1.099-1.315) *** 1.433 (1.257-1.634) *** 1.218 (1.130-1.312) *** 1.412 (1.292-1.542) *** 1.256 (1.141-1.383) *** 1.590 (1.445-1.749) ***
Behavioral characteristicsc
Smoking(ref=never)
  Past smoker 1.375 (0.851-2.220) 2.009 (1.019-3.959) * 0.926 (0.643-1.334) 1.337 (0.868-2.060) 1.315 (0.933-1.855) 1.334 (0.942-1.890)
  Current smoker 1.091 (0.688-1.730) 0.576 (0.241-1.379) 1.067 (0.749-1.521) 0.895 (0.549-1.460) 1.119 (0.786-1.592) 0.906 (0.627-1.309)
Drinking(ref=never)
  Past drinker 1.176 (0.733-1.886) 2.213 (1.141-4.291) * 0.813 (0.563-1.175) 1.003 (0.641-1.570) 1.109 (0.765-1.606) 1.038 (0.714-1.510)
  Current drinker 0.883 (0.570-1.366) 0.649 (0.285-1.476) 0.645 (0.441-0.944) * 0.937 (0.584-1.503) 1.255 (0.895-1.760) 0.861 (0.600-1.236)
Exercise(ref=yes)
  No 1.593 (1.184-2.144) ** 3.822 (2.186-6.683) *** 1.991 (1.561-2.541) *** 3.743 (2.630-5.327) *** 1.432 (1.109-1.849) ** 3.311 (2.511-4.365) ***
Sleep duration [ref=moderate(6-9 h)]
  Short(< 6 h) 1.325 (0.970-1.810) 1.617 (0.957-2.733) 1.199 (0.934-1.539) 1.175 (0.845-1.635) 1.037 (0.788-1.364) 1.355 (1.027-1.787) *
  Long(≥9 h) 1.608 (1.103-2.344) * 2.616 (1.454-4.706) *** 1.372 (1.028-1.831) * 1.973 (1.376-2.829) *** 1.286 (0.974-1.696) 2.096 (1.587-2.768) ***
Depression (ref = no depressive tendency)
  Depressive tendency 2.061 (1.515-2.804) *** 2.321 (1.392-3.868) *** 1.314 (1.042-1.657) * 1.988 (1.458-2.711) *** 1.311 (1.035-1.662) * 1.804 (1.424-2.286) ***
Interpersonal networkc
Living arrangements (ref = living alone)
  Living with children 0.988 (0.659-1.481) 3.180 (1.376-7.345) ** 1.220 (0.933-1.597) 2.441 (1.671-3.566) *** 1.175 (0.884-1.561) 2.554 (1.888-3.455) ***
  Living with spouse 0.994 (0.670-1.474) 2.533 (1.092-5.875) * 1.049 (0.772-1.425) 1.713 (1.108-2.649) * 0.690 (0.457-1.040) 1.550 (1.010-2.378) *
  Living with others 0.800 (0.321-1.990) 3.235 (0.858-12.201) 1.361 (0.721-2.570) 3.080 (1.416-6.701) ** 1.869 (1.108-3.151) * 3.368 (1.976-5.740) ***
Area(ref=Northeastern area)
  Eastern area 1.340 (0.731-2.457) 0.981 (0.551-1.746)
  Midd1earea 1.035 (0.549-1.951) 0.795 (0.434-1.454)
  Western area 1.010 (0.542-1.883) 0.569 (0.313-1.032)
Living and working conditionsc
Education (ref=over 6 years)
  0 year 2.966 (1.891-4.652) *** 3.707 (1.763-7.792) *** 1.582 (1.048-2.387) * 1.487 (0.888-2.490) 1.919 (1.238-2.974) ** 2.668 (1.712-4.160) ***
  1-6 years 1.302 (0.855-1.980) 1.355 (0.667-2.753) 0.919 (0.622-1.356) 0.900 (0.553-1.465) 1.328 (0.882-2.000) 1.173 (0.769-1.790)
Retirement security (ref = yes)
  No 0.874 (0.595-1.283) 0.876 (0.472-1.628) 1.148 (0.851-1.548) 1.187 (0.809-1.741) 0.779 (0.556-1.094) 0.811 (0.574-1.147)
Economic status (ref = rich)
  Moderate 1.521 (0.982-2.355) 1.294 (0.667-2.512) 1.280 (0.943-1.736) 1.063 (0.726-1.558) 0.937 (0.708-1.239) 1.093 (0.823-1.451)
  Poor 2.051 (1.189-3.540) ** 2.216 (0.992-4.950) 1.393 (0.900-2.156) 1.117 (0.642-1.946) 1.301 (0.797-2.123) 2.064 (1.282-3.323) **
Policy environmentc
Old-age insurance (ref= yes)
  No 0.857 (0.660-1.113) 0.853 (0.659-1.106)
Medical insurance(ref=yes)
  No 0.943 (0.652-1.362) 1.598 (1.053-2.426) * 0.998 (0.693-1.436) 1.621 (1.148-2.291) **
1 国家统计局. 第七次全国人口普查主要数据情况[EB/OL]. (2021-05-10) [2024-01-15]. http://www.stats.gov.cn/tjsj/zxfb/202105/t20210510_1817176.html.
2 王金营, 李天然. 中国老年失能年龄模式及未来失能人口预测[J]. 人口学刊, 2020, 42 (5): 57- 72.
3 Edemekong P , Bomgaars D , Sukumaran S , et al. Activities of daily living[M]. StatPearls, Treasure Island (FL): StatPearls Publishing, 2002.
4 Zhang X , Lin L , Sun X , et al. Development and validation of the disability index among older adults[J]. J Gerontol A Biol Sci Med Sci, 2023, 78 (1): 111- 119.
doi: 10.1093/gerona/glac059
5 Vaarst J , Boyle E , Vestergaard S , et al. Does physical performance and muscle strength predict future personal and nursing care services in community-dwelling older adults aged 75 +?[J]. Scand J Public Health, 2021, 49 (4): 441- 448.
doi: 10.1177/1403494820979094
6 Hurd MD , Martorell P , Langa KM . Monetary costs of dementia in the United States[J]. N Engl J Med, 2013, 369 (5): 489- 490.
doi: 10.1056/NEJMc1305541
7 Shimada H , Makizako H , Doi T , et al. Cognitive impairment and disability in older Japanese adults[J]. PLoS One, 2016, 11 (7): e0158720.
doi: 10.1371/journal.pone.0158720
8 曹永红. 我国农村养老保障供需失衡与制度改进研究[D]. 武汉: 华中科技大学, 2018.
9 孙鹃娟, 蒋炜康, 陈雨欣. 医养康养相结合的养老服务体系: 政策意涵与实践路径[J]. 北京行政学院学报, 2023, (2): 109- 118.
doi: 10.3969/j.issn.1008-7621.2023.02.012
10 贺薇. 资源约束下的居家养老服务供给结构优化研究[D]. 武汉: 武汉大学, 2019.
11 陈珍妮, 李嘉雨, 陈娜. 我国城乡居家失能老人未满足照料需求的影响因素分析[J]. 南京中医药大学学报(社会科学版), 2023, 24 (4): 256- 263.
12 刘宗壮, 井力加, 王鑫, 等. 家庭资源禀赋视角下我国农村居家高龄失能老年人日常生活照料需求满足程度及其影响因素研究[J]. 现代预防医学, 2022, 49 (15): 2789- 2794.
13 北京大学健康老龄与发展研究中心. 中国老年健康影响因素跟踪调查(CLHLS)追踪数据(1998—2018) [EB/OL]. (2022-04-03) [2024-01-15]. https://doi.org/10.18170/DVN/WBO7LK.
14 黄匡时. 中国老年人日常生活照料需求研究[J]. 人口与社会, 2014, 30 (4): 10- 17.
doi: 10.3969/j.issn.1007-032X.2014.04.002
15 Burwell B , Jackson B . The disabled elderly and their use of long-term care[M]. U.S.: Department of Health and Human Services, 1994.
16 Zeng Y , Chen H , Wang Z , et al. Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China[J]. J Aging Health, 2015, 27 (3): 519- 550.
doi: 10.1177/0898264314552690
17 潘秋予, 李印龙, 麦陈耀, 等. 健康生态学研究进展[J]. 济宁医学院学报, 2022, 45 (4): 229- 233.
doi: 10.3969/j.issn.1000-9760.2022.04.001
18 Grzywacz JG , Fuqua J . The social ecology of health: Leverage points and linkages[J]. Behav Med, 2000, 26 (3): 101- 115.
doi: 10.1080/08964280009595758
19 于敏. 城镇居民老年人养老需求满足程度研究[D]. 北京: 首都经济贸易大学, 2019.
20 胡岩, 徐凌忠, 苏丽娜, 等. 山东省农村老年人生活照料需求及其影响因素[J]. 山东大学学报(医学版), 2018, 56 (2): 74- 79.
21 Buysse DJ . Evidence-based guidelines for fatigue risk management in emergency medical services: A step in the right direction toward better sleep health[J]. Prehosp Emerg Care, 2018, 22 (Sup1): 3- 5.
doi: 10.1080/10903127.2017.1380099
22 Kim J . Sleep duration and obesity[J]. J Obes Metab Syndr, 2017, 26 (1): 1- 2.
doi: 10.7570/jomes.2017.26.1.1
23 Faulkner S . Sleep and occupational performance are inseparable: Why occupational therapy practice and research should consider sleep and circadian rhythm[J]. Brit J Occup Ther, 2022, 85 (5): 305- 307.
doi: 10.1177/03080226221089846
24 Tokur-Kesgin M , Kocoglu-Tanyer D . Pathways to adolescents ' health: Chronotype, bedtime, sleep quality and mental health[J]. Chronobiol Int, 2021, 38 (10): 1441- 1448.
doi: 10.1080/07420528.2021.1931277
25 孙鹏鹏, 王越, 张剑妹, 等. 农村老年人养老需求及其影响因素的研究[J]. 解放军护理杂志, 2017, 34 (3): 13- 17.
26 Cohen AK , Syme SL . Education: A missed opportunity for public health intervention[J]. Am J Public Health, 2013, 103 (6): 997- 1001.
doi: 10.2105/AJPH.2012.300993
27 江克忠, 陈友华. 亲子共同居住可以改善老年人的心理健康吗?——基于CLHLS数据的证据[J]. 人口学刊, 2016, 38 (6): 77- 86.
28 张莉. 谁在照顾老人: 过去、现在与将来[J]. 人口与健康, 2020, (2): 22- 26.
29 陈璐, 王璐. 社区照料服务可及性对城市老年人生活满意度的影响[J]. 中国人口科学, 2023, 37 (1): 56- 69.
30 徐赞, 邓云龙. 大学生危险和有害饮酒现状及影响因素分析[J]. 中国临床心理学杂志, 2016, 24 (1): 36- 40.
31 赵凤, 宫凤凤, 黄玉君, 等. 安徽省农村老年人危险和有害饮酒及尼古丁依赖现状[J]. 中华行为医学与脑科学杂志, 2017, 26 (3): 255- 261.
32 Mangyo E , Park A . Relative deprivation and health: Which refe-rence groups matter?[J]. J Hum Resour, 2011, 46 (3): 459- 481.
33 中华人民共和国国家卫生健康委员会. 2021年我国卫生健康事业发展统计公报[J]. 中国实用乡村医生杂志, 2022, 29 (9): 1- 11.
doi: 10.3969/j.issn.1672-7185.2022.09.001
34 蒋淑敏. 中国老年人日常生活能力及影响因素研究[D]. 郑州: 郑州大学, 2019.
35 黄方肇. 农村养老保障能力区域差异下的养老需求研究[D]. 南昌: 江西中医药大学, 2021.
36 陶丽丽, 王超群, 于琳娜. 失能老人生活照料需求未满足状况及其影响因素: 基于2005—2018年CLHLS数据的分析[J]. 中国卫生经济, 2022, 41 (8): 49- 52.
[1] 刘园梅, 傅义程, 郝靖欣, 张福春, 刘慧琳. 老年髋部骨折患者住院期间发生术后心力衰竭的列线图预测模型的构建及验证[J]. 北京大学学报（医学版）, 2024, 56(5): 874-883.
[2] 靖婷,江华,李婷,申倩倩,叶兰,曾银丹,梁文欣,冯罡,司徒文佑,张玉梅. 中国西部5城市中老年人血清25羟基维生素D与握力的相关性[J]. 北京大学学报（医学版）, 2024, 56(3): 448-455.
[3] 林郁婷,王华丽,田宇,巩俐彤,常春. 北京市老年人认知功能的影响因素[J]. 北京大学学报（医学版）, 2024, 56(3): 456-461.
[4] 汤华萌,袁典琪,王明星,杨晗冰,郭超. 数字融入和健康生活方式对社会经济状况与老年人抑郁关系的序列中介作用[J]. 北京大学学报（医学版）, 2024, 56(2): 230-238.
[5] 刘慧丽,吕彦函,王晓晓,李民. 老年患者腹腔镜泌尿系肿瘤根治术后慢性疼痛的影响因素[J]. 北京大学学报（医学版）, 2023, 55(5): 851-856.
[6] 祝春素,连至炜,崔一民. 中国中老年人抑郁和慢性病的关联[J]. 北京大学学报（医学版）, 2023, 55(4): 606-611.
[7] 刘光奇,庞元捷,吴疆,吕敏,于孟轲,李雨橦,黄旸木. 2013—2019年流感季北京市住院老年人流感疫苗接种趋势分析[J]. 北京大学学报（医学版）, 2022, 54(3): 505-510.
[8] 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.
[9] 李佳,徐钰,王优雅,高占成. 老年流感肺炎的临床特征及D-二聚体与疾病严重程度的相关性[J]. 北京大学学报（医学版）, 2022, 54(1): 153-160.
[10] 敖明昕,李学民,于媛媛,时会娟,黄红拾,敖英芳,王薇. 视觉重建对老年人行走动态足底压力的影响[J]. 北京大学学报（医学版）, 2021, 53(5): 907-914.
[11] 彭顺壮, 付茜茜, 冯星淋. 中国中老年居民教育程度与失能发生:社会参与的中介作用[J]. 北京大学学报（医学版）, 2021, 53(3): 549-554.
[12] 陈家丽,金月波,王一帆,张晓盈,李静,姚海红,何菁,李春. 老年发病类风湿关节炎的临床特征及其心血管疾病危险因素分析:一项大样本横断面临床研究[J]. 北京大学学报（医学版）, 2020, 52(6): 1040-1047.
[13] 王哲斌,郑志杰. 中国中老年人失能状况公平性与影响因素[J]. 北京大学学报（医学版）, 2020, 52(3): 500-505.
[14] 陈健,左才红,张财义,杨明,张培训. 解剖型髓内钉和股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效比较[J]. 北京大学学报（医学版）, 2019, 51(2): 283-287.
[15] 徐小凤，陈茜，赵艺璞，胡秀英. 我国西部地区居家老年人生活自理能力调查分析[J]. 北京大学学报(医学版), 2018, 50(3): 457-462.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
ISSN 1671-167X
CN 11-4691/R
主管单位：中华人民共和国教育部
主办单位：北京大学
地址： 北京市海淀区学院路38号 北京大学医学部 《北京大学学报（医学版）》
邮编：100191
电话：010-82801551
Email： xbbjb2@bjmu.edu.cn

《北京大学学报（医学版）》
微信公众号
版权所有 © 2018 《北京大学学报（医学版）》编辑部