老年人衰弱的影响因素分析

张艳; 梁亚萍; 孙铭薇; 黄玲凤; 练婷玉; 黄景晓; 尹明娟; 倪进东

doi:10.16462/j.cnki.zhjbkz.2019.02.004

老年人衰弱的影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2019.02.004

1.
523808 东莞, 广东医科大学公共卫生学院流行病与卫生统计学教研室
2.
518000 深圳, 深圳市南山区慢性病防治院慢病科

基金项目:

广东省东莞市社会科技发展项目 201650715000528

详细信息

通讯作者:
倪进东, E-mail: nijd-gw@gdmu.edu.cn

中图分类号: R161.7
计量
- 文章访问数: 423
- HTML全文浏览量: 258
- PDF下载量: 59
- 被引次数: 0
出版历程
- 收稿日期: 2018-10-27
- 修回日期: 2018-12-24
- 刊出日期: 2019-02-10

Analysis on influencing factors of the frailty of the elderly

1.
Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan 523808, China
2.
Chronic disease department, Shenzhen Nanshan District Chronic Disease Prevention and Treatment Institute, Shenzhen 518000, China

Funds:

Dongguan City Social Science and Technology Development Project 201650715000528

More Information

Corresponding author: NI Jin-dong, E-mail: nijd-gw@gdmu.edu.cn

摘要

摘要: 目的探索老年人衰弱的影响因素。方法从东莞市大朗镇随机抽取8个社区，采用项目开发的衰弱指数量表调查符合条件的老年人。采用χ²检验进行单因素分析，有序多分类Logistic回归进行多因素分析。结果单因素分析结果显示，不同人口学特点、家庭关系、经济情况及生活方式的老人衰弱情况分布有差异，且差异均有统计学意义（均有P<0.05）。多因素分析显示，低年龄（OR=0.13，P<0.001）、男性（OR=0.65，P=0.012）、每天锻炼身体（OR=0.76，P=0.049）是老年人衰弱的保护因素。未接受教育（OR=2.42，P<0.001）、每月见到子女次数较少（OR=1.82，P=0.035）、以养老金为主要经济来源（OR=1.59，P<0.001）、低体力活动水平（OR=2.18，P<0.001）及不进行社会参与活动（OR=1.41，P=0.004）是衰弱发生的危险因素。结论年龄、性别、受教育程度、每月见到子女次数、经济来源、锻炼身体频率、体力活动水平及社会参与情况是老年人衰弱的影响因素。
- 老年卫生 /
- 社区老人 /
- 衰弱 /
- 影响因素
Abstract: Objective To explore influencing factors of the elderly's frailty. Methods Eight communities were randomly selected from Dalang Town, Dongguan City, and all the eligible elderly people were investigated using the self-developed frailty index. Univariate analysis was performed using the χ² test, and multivariate analysis was performed by ordinal multi-class Logistic regression. Results Univariate analysis showed that there were significant differences in the distribution of frailty conditions among different demographic characteristics, family relationships, economic situation and lifestyle (all P<0.05). Multivariate analysis showed that younger age (OR=0.13, P<0.001), male (OR=0.65, P=0.012), and daily exercise (OR=0.76, P=0.049) were protective factors for frailty of the elderly. Illiterate (OR=2.42, P<0.001), fewer times to see children per month (OR=1.82, P=0.035), pension funds as the main economic source (OR=1.59, P<0.001), low level of physical activity (OR=2.18, P<0.001) and none social participation (OR=1.41, P=0.004) were risk factors of frailty. Conclusion Age, gender, education level, times to see children per month, economic source, exercise frequency, physical activity level and social participation are the influencing factors of frailty of the elderly.
- Geriatric health /
- Community elderly /
- Frailty /
- Influencing factors

HTML全文

表 1 被调查者的一般人口学资料

Table 1. General demographic data of respondents

特征	人数	百分比(%)	特征	人数	百分比(%)
性别			文化程度
男	1 225	39.1	未受教育	637	20.3
女	1 908	60.9	小学	1 770	56.5
年龄(岁)			初中及以上	727	23.2
60~	1 795	57.3	居住情况
70~	852	27.2	独居	398	12.7
≥80	486	15.5	与伴侣居住	749	23.9
婚姻状况			与子女居住	1 344	42.9
已婚	2 506	80.0	与伴侣、子女居住	636	20.3
丧偶	614	19.6	与其他人居住	6	0.2
离婚/未婚	13	0.4

下载: 导出CSV

表 2 一般人口学特点对老年人衰弱分布的影响[n(%)]

Table 2. The impact of general demographic characteristics on the distribution of frailty[n(%)]

项目	衰弱状态			χ²值	P值
项目	健康	衰弱前期	衰弱	χ²值	P值
性别				66.9	＜0.001
男	718(58.6)	391(31.9)	116(9.5)
女	525(41.3)	805(40.3)	368(18.4)
年龄(岁)				463.7	＜0.001
60~	1 102(61.4)	601(33.5)	92(5.1)
70~	316(37.0)	383(44.9)	154(18.1)
≥80	70(14.4)	171(35.2)	245(50.4)
文化程度				313.0	＜0.001
未受教育	118(18.6)	276(43.3)	243(38.1)
小学	931(52.6)	647(36.6)	191(10.8)
初中及以上	465(63.9)	231(31.8)	31(4.3)
婚姻状况				167.9	＜0.001
已婚	1 365(54.5)	882(35.2)	258(10.3)
离婚/未婚/丧偶	163(26.0)	259(41.3)	206(32.8)
居住情况				221.7	＜0.001
独居	84(21.2)	154(38.6)	160(40.3)
与伴侣居住	327(43.7)	279(37.3)	143(19.1)
与子女居住	788(58.6)	460(34.2)	97(7.2)
与伴侣、子女居住	300(47.2)	259(40.7)	76(12.0)
与其他人居住	2(25.0)	0(0.0)	4(75.0)

下载: 导出CSV

表 3 家庭关系对老年人衰弱分布的影响[n(%)]

Table 3. The impact of family relationships on the distribution of frailty[n(%)]

项目	衰弱状态			χ²值	P值
项目	健康	衰弱前期	衰弱	χ²值	P值
子女数				121.4	<0.001
0~	34(40.4)	36(42.6)	14(17.0)
2~	1 175(54.1)	795(36.6)	202(9.3)
≥4	313(35.7)	322(36.7)	242(27.6)
每月见到子女次数				32.6	<0.001
1~	25(24.6)	46(46.2)	29(29.2)
3~	43(34.5)	51(40.5)	31(25.0)
≥5	1 468(50.5)	1 052(36.2)	387(13.3)
与子女关系				14.8	0.001
融洽	1 487(49.2)	1 112(36.8)	423(14.0)
不融洽	40(36.7)	35(31.7)	35(31.7)

下载: 导出CSV

表 4 经济情况对老年人衰弱分布的影响[n(%)]

Table 4. The impact of economic conditions on the distribution of frailty[n(%)]

项目	衰弱状态			χ²值	P值
项目	健康	衰弱前期	衰弱	χ²值	P值
是否从事有收入的工作				48.4	<0.001
是	326(64.2)	145(28.5)	37(7.3)
否	1 184(45.1)	1 011(38.5)	431(16.4)
是否购买商业保险				4.4	0.108
是	282(55.6)	164(32.2)	62(12.3)
否	1 276(48.6)	958(36.5)	391(14.9)
养老金是否为主要经济来源				62.3	<0.001
是	620(40.5)	614(40.1)	297(19.4)
否	909(56.8)	527(32.9)	165(10.3)
住房满意度				12.7	0.013
满意	1 351(49.5)	996(36.5)	382(14.0)
一般	155(41.5)	138(36.9)	81(21.6)
不满意	11(34.8)	13(43.5)	7(21.7)

下载: 导出CSV

表 5 不同生活方式对老年人衰弱分布的影响[n(%)]

Table 5. The impact of different lifestyles on the distribution of the frailty[n(%)]

项目	衰弱状态			χ²值	P值
	健康	衰弱前期	衰弱	χ²值	P值
	抽烟情况				63.6	<0.001
抽烟	416(63.8)	192(29.5)	44(6.7)
曾经抽烟	416(48.5)	304(35.4)	139(16.2)
从不抽烟	678(41.8)	675(41.6)	271(16.7)
饮酒情况				19.7	<0.001
是	124(65.0)	56(29.4)	11(5.6)
否	1 392(47.3)	1 094(37.2)	456(15.5)
锻炼身体				103.1	<0.001
每天	933(50.4)	756(40.8)	161(8.7)
小于5次/周	82(52.3)	57(36.4)	18(11.4)
小于2次/周	521(46.3)	317(28.2)	287(25.5)
体力活动水平				209.4	<0.001
低	211(33.9)	181(29.0)	231(37.1)
中	233(39.0)	246(41.2)	118(19.8)
高	1 072(56.0)	710(37.1)	132(6.9)
社会参与				109.5	<0.001
是	872(54.9)	607(38.2)	110(6.9)
否	643(41.6)	545(35.3)	357(23.1)

下载: 导出CSV

表 6 老年衰弱影响因素的多因素分析

Table 6. Multivariate analysis of factors influencing frailty of the elderly

项目	Wald值	OR(95% CI)值	P值
衰弱状态=健康	4.56		<0.001
衰弱状态=衰弱前期	6.05		<0.001
性别
男	6.28	0.65(0.47~ 0.91)	0.012
女		1.00
年龄(岁)
60~	78.67	0.13(0.09~0.21)	<0.001
70~	26.29	0.35(0.24~0.53)	<0.001
≥80		1.00
教育程度
未受教育	19.13	2.42(1.63~3.60)	<0.001
初中及以上		1.00
子女每月拜访次数
3~4次	4.44	1.82(1.04~3.19)	0.032
5次及以上		1.00	.
养老金是否为主要经济来源
是	15.93	1.59(1.27~1.99)	<0.001
否		1.00	.
锻炼身体频率
每天	3.88	0.76(0.57~0.99)	0.049
少于2次/周		1.00	.
体力活动水平
低	23.26	2.18(1.59~2.99)	<0.001
中	7.71	1.50(1.13~1.99)	0.006
高		1.00	.
社会参与
否	23.10	1.41(1.12~1.77)	0.004
是		1.00	.

下载: 导出CSV

参考文献(22)

[1]	Buchner DM, Wagner EH. Preventing frail health[J]. Clin Geriatri Med, 1992, 8(1): 1-17. DOI: 10.1016/S0749-0690(18)30494-4.
[2]	孙凯旋, 刘永兵, 薛谨, 等. 住院老年衰弱综合征患者与生命质量关系的调查分析[J]. 国际护理学杂志, 2018, 37(1): 41-45. DOI: 10.3760/cma.j.issn.1673-4351.2018.01.011. Sun KX, Liu YB, Xue J, et al. The investigation and analysis of the relationship between patients with senile asthe-nia syndrome and the quality of life[J]. Int J Nurs, 2018, 37(1): 41-45. DOI: 10.3760/cma.j.issn.1673-4351.2018.01.011.
[3]	Song XW, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation[J]. J Am Geriatri Soc, 2010, 58(4): 681-687. DOI: 10.1111/j.1532-5415.2010.02764.x.
[4]	Singh M, Stewart R, While H. Importance of frailty in patients with cardiovascular disease[J]. Eur Heart J, 2014, 35(26): 1726. DOI: 10.1093/eurheartj/ehu197.
[5]	Wyrko Z. Frailty at the front door[J]. Clin Med, 2015, 15(4): 377-381. DOI: 10.7861/clinmedicine.15-4-377.
[6]	Tarazona-Santabalbina FJ, Gómez-Cabrera MC, Pérez-Ros P, et al. A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: A Randomized Clinical Trial[J]. J Am Med Dir Assoc, 2016, 17(5): 426-433. DOI: 10.1016/j.jamda.2016.01.019.
[7]	Cameron ID, Fairhall N, Langron C, et al. A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial[J]. BMC Medicine, 2013, 11(1): 65. DOI: 10.1186/1741-7015-11-65.
[8]	Kim H, Suzuki T, Kim M, et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail japanese women: a randomized double Blind, Placebo-Controlled, Follow-Up Trial[J]. PLoS One, 2015, 10(2): e0116256. DOI: 10.1371/journal.pone.0116256.
[9]	罗如珍, 杨洋, 张春梅, 等. 社区老年人衰弱水平及影响因素研究[J]. 中国实用护理杂志, 2017, 33(15): 1169-1173. DOI: 10.3760/cma.j.issn.1672-7088.2017.15.012. Luo RZ, Yang Y, Zhang CM, et al. Study on the frailty level and influencing factors of elderly people in community[J]. China J Pra Nurs, 2017, 33(15): 1169-1173. DOI: 10.3760/cma.j.issn.1672-7088.2017.15.012.
[10]	孟丽, 谭潇, 石婧, 等. 老年人衰弱分布及其影响因素的初步研究[J]. 中国临床保健杂志, 2017, 20(5): 481-485. DOI: 10.3969/J.issn.1672-6790.2017.05.001. Meng L, Tan X, Shi Q, et al. A preliminary study on the distribution of frailty in the elderly and its influencing factors[J]. Chinese Journal of Clinical Healthcare, 2017, 20(5): 481-485. DOI: 10.3969/J.issn.1672-6790.2017.05.001.
[11]	詹思延. 流行病学[M]. 第8版. 2017, 北京: 人民卫生出版社. 42-47. Zhan SY. Epidemiology[M]. Edition 8. 2017, Beijing: people's health publishing house. 42-47.
[12]	黄斯梅, 黄荟森, 蒙明虑, 等. 广西壮族自治区高中及中职在校生戊型肝炎病毒IgG抗体阳性率的调查[J]. 中华疾病控制杂志, 2018, 22(5): 535-537. DOI: 10.16462/j.cnki.zhjbkz.2018.05.024. Huang SM, Huang HS, Meng ML, et al, A sampling survey for the prevalence of anti HEV-IgG in the students of high schools and secondary vocational schools in Guangxi Zhuang Autonomous Region[J]. Chin J Dis Control Prev, 2018, 22(5): 535-537. DOI: 10.16462/j.cnki.zhjbkz.2018.05.024.
[13]	Collard RM, Boter H, Schoevers RA, et al. Prevalence of frailty in community-dwelling older persons: a systematic review[J]. J An Geriats Soc, 2012, 60(8): 1487-1492. DOI: 10.1111/j.1532-5415.2012.04054.x.
[14]	Xue QL. The frailty syndrome: definition and natural history[J]. Clin Geriatr Med, 2011, 27(1): 1-15. DOI: 10.1016/j.cger.2010.08.009.
[15]	Liu LK, Lee WJ, Chen LY, et al. Association between Frailty, osteoporosis, falls and hip fractures among community-dwelling people aged 50 years and older in taiwan: results from I-Lan longitudinal aging study[J]. PLoS One, 2015, 10(9): e0136968. DOI: 10.1371/journal.pone.0136968.
[16]	孙凯旋, 刘永兵, 薛谨, 等. 基于老年综合评估体系构建的衰弱指数模型在老年住院患者中的应用[J]. 中华老年病研究电子杂志, 2017, 4(2): 43-47. DOI: 10.3877/cma.j.issn.2095-8757.2017.02.008. Sun KX, Liu YB, Xue J, et al. Application of frailty index based on a comprehensive geriatric assessment in hospitalized elderly patients[J]. Chin J Geiatrics Res(Electronic Edition), 2017, 4(2): 43-47. DOI: 10.3877/cma.j.issn.2095-8757.2017.02.008.
[17]	王坤, 陈长香, 李淑杏. 石家庄某社区老年人衰弱现状及影响因素[J]. 中国公共卫生, 2018, 34(2): 196-198. DOI: 10.11847/zgggws1114001. Wang K, Chen CX, Li SX. Prevalence and influencing factors of frailty among community elderly people in Shijiazhuang city[J]. Chin J Public Health, 2018, 34(2): 196-198. DOI: 10.11847/zgggws1114001.
[18]	Jürschik P, Nunin C, Botigué T, et al. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey[J]. Arch Gerontol Geriatr, 2012, 55(3): 625-631. DOI: 10.1016/j.archger.2012.07.002.
[19]	Ferreira CB, Teixeira P, Alves GDS, et al. Effects of a 12-week exercise training program on physical function in institutionalized frail elderly[J]. J Aging Res, 2018, 2018(1): 1-8. DOI: 10.1155/2018/7218102.
[20]	Theou O, Stathokostas L, Roland KP, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review[J]. J Aging Res, 2011, 2011(3): 569194. DOI: 10.4061/2011/569194.
[21]	Cesari M, Vellas B, Hsu FC, et al. A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study[J]. Journals of Gerontology, 2015, 70(2): 216-22. DOI: 10.1093/gerona/glu099.
[22]	Eyigor S, Kutsal YG, Duran E, et al. Frailty prevalence and related factors in the older adult-FrailTURK Project[J]. Age, 2015, 37(3): 50. DOI: 10.1007/s11357-015-9791-z.