基于心理健康维度的农村老年人健康预期寿命测算——多状态马尔科夫模型

王重建; 胡泽; 江凤; 刘晓田; 李润鑫

doi:10.16462/j.cnki.zhjbkz.2024.03.008

基于心理健康维度的农村老年人健康预期寿命测算——多状态马尔科夫模型

doi: 10.16462/j.cnki.zhjbkz.2024.03.008

郑州大学公共卫生学院流行病与卫生统计学系，郑州 450001

基金项目:

河南省哲学社会科学规划项目 2020BSH018

国家重点研发计划 2016YFC0900803

详细信息

通讯作者:
王重建，E-mail：tjwcj2008@zzu.edu.cn

中图分类号: R195.3
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- 被引次数: 0
出版历程
- 收稿日期: 2023-09-28
- 修回日期: 2024-01-09
- 网络出版日期: 2024-04-08
- 刊出日期: 2024-03-10

Healthy life expectancy for rural older population based on mental health: multistate Markov modeling

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China

Funds:

Philosophy and Social Science Planning Project of Henan Province 2020BSH018

National Key Program of Research and Development of China 2016YFC0900803

More Information

Corresponding author: WANG Chongjian, Email: tjwcj2008@zzu.edu.cn

摘要

摘要: 目的评估农村老年人基于心理维度的预期寿命(life expectancy, LE)和健康预期寿命(healthy life expectancy, HLE)，以便提出延长农村老年人LE和HLE的对策建议。方法基于“河南农村队列”基线和随访调查数据，通过多状态寿命表法分年龄性别计算农村≥60岁老年人群的LE和HLE。所计算的HLE指标包括无抑郁或焦虑症状预期寿命(depression-or anxiety-free life expectancy, DAFLE)、无抑郁症状预期寿命(depression-free life expectancy, DFLE)和无焦虑症状预期寿命(anxiety-free life expectancy, AFLE)。结果 60岁总人群的DAFLE、DFLE和AFLE分别为20.081 5岁、20.230 1岁和20.435 2岁，分别占LE的95.85%、96.28%和96.99%；60岁男性的DAFLE、DFLE和AFLE分别为18.076 8岁、18.012 8岁和18.166 5岁，分别占LE的96.70%、97.10%和97.41%；60岁女性的DAFLE、DFLE和AFLE分别为22.811 6岁、23.325 3岁和23.492 2岁，分别占LE的95.33%、95.59%和96.57%。结论农村老年女性HLE/LE值低于男性，提示抑郁症状和焦虑症状对女性生命质量的影响大于男性。
- 健康预期寿命 /
- 抑郁 /
- 焦虑 /
- 多状态寿命表法 /
- 多状态马尔科夫模型
Abstract: Objective This study aimed to estimate the life expectancy (LE) healthy life expectancy (HLE) indicators regarding depression and anxiety symptoms to quantify the impact of them on the health of the elderly population in order to provide recommendations for countermeasures to prolong HLE in rural areas. Methods Participants aged 60 and older from the baseline study and the follow-up study of the "Henan Rural Cohort Study" were used to evaluate LE and HLE indicators across age and gender. In the present study, the HLE indicators included depression-or anxiety-free life expectancy (DAFLE), depression-free life expectancy (DFLE) and anxiety-free life expectancy (AFLE). Results Based on the data from the baseline and the follow-up survey of "Henan rual cohort", the DAFLE, DFLE, AFLE was measured via multistate life tables. For those who were 60 years old, the DAFLE, DFLE and AFLE were 20.081 5, 20.230 1 and 20.435 2 years, accounting for 95.85%, 96.28% and 96.99% of LE, respectively. For men aged 60 years old, the DAFLE, DFLE and AFLE were 18.076 8, 18.012 8 and 18.166 5 years, accounting for 96.70%, 97.10% and 97.41% of LE, respectively. For women aged 60, the DAFLE, DFLE and AFLE were 22.811 6, 23.325 3 and 23.492 2 years, which accounted for 95.33%, 95.59% and 96.57%, respectively. Conclusions The ratio of HLE to LE were higher among men than women, which suggest that depression and anxiety effected the quality of life among elderly women more severely than among men.
- Healthy life expectancy /
- Depression /
- Anxiety /
- Multistate life table /
- Multistate Markov model

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图 1 不同健康状态间的转换模式

Figure 1. Transitions pattern between different health states

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表 1 研究对象的一般人口学特征

Table 1. Demographic characteristics of the participants

变量Variable	男性 ^① Men ^① (n=4 111)	女性 ^① Women ^① (n=4 971)	P值 value
年龄/岁Age /years	67.09(4.86)	66.67(4.85)	< 0.001
抑郁症状Depression symptom			< 0.001
无Yes	3 905(94.99)	4 571(91.95)
有No	206(5.01)	400(8.05)
焦虑症状Anxiety symptom			< 0.001
无Yes	3 955(96.21)	4 605(92.64)
有No	156(3.79)	366(7.36)
注：①以人数(占比/%)或M(P₂₅，P₇₅)表示。 Note: ① Number of people (proportion/%) or M(P₂₅，P₇₅).

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表 2 不同性别、年龄人群的LE、DAFLE及其相关指标

Table 2. LE, DAFLE and related indicators in defferent gender and age

年龄/岁 Age/years	总人群Total			男性Men			女性Women
年龄/岁 Age/years	LE/岁 years	DAFLE/岁 years	DAFLE/LE/%	LE/岁 years	DAFLE/岁 years	DAFLE/LE/%	LE/岁 years	DAFLE/岁 years	DAFLE/LE/%
60	20.951 0	20.081 5	95.85	18.693 3	18.076 8	96.70	23.929 4	22.811 6	95.33
61	20.142 5	19.366 8	96.15	17.911 5	17.391 5	97.10	23.094 6	22.081 3	95.61
62	19.332 8	18.588 1	96.15	17.135 5	16.640 9	97.11	22.250 7	21.277 2	95.62
63	18.534 0	17.817 5	96.13	16.372 9	15.900 2	97.11	21.415 3	20.478 5	95.63
64	17.747 4	17.058 6	96.12	15.624 4	15.173 2	97.11	20.589 8	19.689 1	95.63
65	16.973 5	16.312 2	96.10	14.890 7	14.460 6	97.11	19.774 6	18.909 7	95.63
66	16.213 2	15.579 0	96.09	14.172 5	13.763 0	97.11	18.970 6	18.141 0	95.63
67	15.467 0	14.859 6	96.07	13.470 4	13.081 1	97.11	18.178 4	17.383 5	95.63
68	14.735 7	14.154 7	96.06	12.785 1	12.415 4	97.11	17.398 7	16.637 9	95.63
69	14.019 9	13.464 9	96.04	12.117 0	11.766 5	97.11	16.632 1	15.904 9	95.63
70	13.320 4	12.790 8	96.02	11.466 8	11.135 0	97.11	15.879 4	15.185 1	95.63
71	12.637 6	12.133 1	96.01	10.835 1	10.521 3	97.10	15.141 1	14.479 1	95.63
72	11.972 3	11.492 3	95.99	10.222 2	9.926 0	97.10	14.418 0	13.787 6	95.63
73	11.325 0	10.868 9	95.97	9.628 7	9.349 5	97.10	13.710 7	13.111 2	95.63
74	10.696 3	10.263 6	95.95	9.054 9	8.792 2	97.10	13.019 9	12.450 5	95.63
75	10.086 5	9.676 6	95.94	8.501 2	8.254 4	97.10	12.346 1	11.806 1	95.63
76	9.496 3	9.108 5	95.92	7.967 9	7.736 4	97.09	11.689 9	11.178 6	95.63
77	8.925 9	8.559 7	95.90	7.455 2	7.238 4	97.09	11.051 9	10.568 4	95.63
78	8.375 8	8.030 4	95.88	6.963 4	6.760 6	97.09	10.432 5	9.976 0	95.62
79	7.846 2	7.521 0	95.85	6.492 4	6.303 0	97.08	9.832 4	9.402 0	95.62
注：LE，预期寿命；DAFLE，无抑郁或焦虑症状预期寿命。 Note: LE, life expectancy; DAFLE，depression-or anxiety-free life expectancy.

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表 3 不同性别、年龄人群的LE、DFLE及其相关指标

Table 3. LE, DFLE and related indicators in defferent gender and age

年龄/岁 Age/years	总人群Total			男性Men			女性Women
年龄/岁 Age/years	LE/岁 years	DFLE/岁 years	DFLE/LE/%	LE/岁 years	DFLE/岁 years	DFLE/LE/%	LE/岁 years	DFLE/岁 years	DFLE/LE/%
60	21.011 7	20.230 1	96.28	18.550 5	18.012 8	97.10	24.402 1	23.325 3	95.59
61	20.215 8	19.542 9	96.67	17.783 2	17.351 3	97.57	23.580 5	22.619 3	95.92
62	19.405 9	18.758 3	96.66	17.013 2	16.599 2	97.57	22.735 0	21.805 7	95.91
63	18.607 3	17.983 8	96.65	16.256 7	15.859 5	97.56	21.898 4	20.999 9	95.90
64	17.821 1	17.221 3	96.63	15.514 8	15.133 9	97.55	21.071 7	20.203 8	95.88
65	17.047 7	16.471 5	96.62	14.787 8	14.423 2	97.53	20.255 5	19.417 9	95.86
66	16.287 9	15.735 0	96.61	14.076 5	13.727 9	97.52	19.450 3	18.642 8	95.85
67	15.542 4	15.012 4	96.59	13.381 5	13.048 5	97.51	18.656 8	17.879 1	95.83
68	14.811 7	14.304 3	96.57	12.703 2	12.385 6	97.50	17.875 5	17.127 4	95.81
69	14.096 4	13.611 3	96.56	12.042 3	11.739 7	97.49	17.107 1	16.388 2	95.80
70	13.397 3	12.934 1	96.54	11.399 2	11.111 4	97.47	16.352 2	15.662 1	95.78
71	12.714 9	12.273 2	96.53	10.774 5	10.501 0	97.46	15.611 4	14.949 8	95.76
72	12.049 8	11.629 1	96.51	10.168 6	9.909 1	97.45	14.885 4	14.251 7	95.74
73	11.402 5	11.002 4	96.49	9.581 9	9.336 1	97.43	14.174 7	13.568 6	95.72
74	10.773 5	10.393 6	96.47	9.014 8	8.782 2	97.42	13.479 8	12.900 9	95.70
75	10.163 5	9.803 2	96.45	8.467 6	8.247 8	97.41	12.801 5	12.249 1	95.68
76	9.572 7	9.231 5	96.44	7.940 5	7.733 2	97.39	12.140 2	11.613 9	95.66
77	9.001 6	8.679 0	96.42	7.433 7	7.238 5	97.37	11.496 5	10.995 7	95.64
78	8.450 5	8.145 9	96.40	6.947 5	6.763 8	97.36	10.870 9	10.395 0	95.62
79	7.919 8	7.632 6	96.37	6.481 8	6.309 3	97.34	10.263 8	9.812 2	95.60
注：LE，预期寿命；DFLE，无抑郁症状预期寿命。 Note: LE, life expectancy; DFLE，depression-free life expectancy.

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表 4 不同性别、年龄人群的LE、AFLE及其相关指标

Table 4. LE, AFLE and related indicators in defferent gender and age

年龄/岁 Age/years	总人群Total			男性Men			女性Women
年龄/岁 Age/years	LE/岁 years	AFLE/岁 years	AFLE/LE/%	LE/岁 years	AFLE/岁 years	AFLE/LE/%	LE/岁 years	AFLE/岁 years	AFLE/LE/%
60	21.070 1	20.435 2	96.99	18.649 1	18.166 5	97.41	24.326 3	23.492 2	96.57
61	20.253 7	19.648 9	97.01	17.874 8	17.413 8	97.42	23.477 3	22.678 6	96.60
62	19.448 8	18.873 0	97.04	17.113 6	16.673 6	97.43	22.637 3	21.872 9	96.62
63	18.656 1	18.108 2	97.06	16.366 0	15.946 3	97.44	21.806 7	21.075 9	96.65
64	17.876 1	17.355 1	97.09	15.632 7	15.232 6	97.44	20.986 3	20.288 0	96.67
65	17.109 4	16.614 4	97.11	14.914 3	14.533 2	97.44	20.176 5	19.509 9	96.70
66	16.356 6	15.886 6	97.13	14.211 2	13.848 5	97.45	19.378 0	18.742 2	96.72
67	15.618 3	15.172 3	97.14	13.524 2	13.179 1	97.45	18.591 3	17.985 4	96.74
68	14.895 2	14.472 2	97.16	12.853 6	12.525 6	97.45	17.817 2	17.240 2	96.76
69	14.187 7	13.786 8	97.17	12.200 1	11.888 5	97.45	17.056 1	16.507 3	96.78
70	13.496 5	13.116 8	97.19	11.564 1	11.268 2	97.44	16.308 7	15.787 1	96.80
71	12.822 1	12.462 6	97.20	10.946 1	10.665 4	97.43	15.575 7	15.080 3	96.82
72	12.165 0	11.824 9	97.20	10.346 5	10.080 2	97.43	14.857 5	14.387 4	96.84
73	11.525 7	11.204 0	97.21	9.765 7	9.513 2	97.42	14.154 8	13.709 2	96.85
74	10.904 7	10.600 6	97.21	9.203 9	8.964 8	97.40	13.468 1	13.046 1	96.87
75	10.302 4	10.015 0	97.21	8.661 6	8.435 0	97.38	12.798 0	12.398 7	96.88
76	9.719 1	9.447 6	97.21	8.138 8	7.924 4	97.36	12.145 0	11.767 4	96.89
77	9.155 2	8.898 9	97.20	7.635 9	7.432 9	97.34	11.509 6	11.152 9	96.90
78	8.611 1	8.369 0	97.19	7.152 9	6.960 8	97.31	10.892 2	10.555 6	96.91
79	8.086 8	7.858 2	97.17	6.689 8	6.508 1	97.28	10.293 2	9.975 8	96.92
注：LE，预期寿命；AFLE，无焦虑症状预期寿命。 Note: LE, life expectancy; AFLE，anxiety-free life expectancy.

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