基于ROC曲线的安徽省农村地区老年人生命质量及拐点年龄分析

朱维正; 张敏; 何欣然; 孙谦; 刘雨阳; 丁宏

doi:10.16462/j.cnki.zhjbkz.2022.05.018

基于ROC曲线的安徽省农村地区老年人生命质量及拐点年龄分析

doi: 10.16462/j.cnki.zhjbkz.2022.05.018

230032 合肥，安徽医科大学卫生管理学院卫生管理系

基金项目:

安徽省高校人文社会科学研究项目 SK2018A0165

详细信息

通讯作者:
丁宏，E-mail: dinghong_cn2003@163.com

中图分类号: R195
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出版历程
- 收稿日期: 2021-07-16
- 修回日期: 2021-10-08
- 网络出版日期: 2022-05-11
- 刊出日期: 2022-05-10

Analysis of quality of life and inflection point age of the elderly in rural areas of Anhui Province based on ROC curve

Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei 230032, China

Funds:

Research Project of Humanities and Social Sciences in Colleges and Universities of Anhui Province SK2018A0165

More Information

Corresponding author: DING Hong, E-mail: dinghong_cn2003@163.com

摘要

摘要: 目的评估安徽省农村地区老年人生命质量及其拐点年龄的性别差异，为提高农村老年人生命质量提供参考。方法采用多阶段分层整群抽样法抽取安徽省18个村为调查现场，共调查老年人3 336名，采用欧洲五维度健康量表(five-dimensional European quality of health scale, EQ-5D)评估老年人生命质量，受试者工作特征(receiver operator characteristic, ROC)曲线预测老年人生命质量拐点年龄，二元Logistic回归分析模型验证拐点年龄对生命质量的预测能力。结果健康效用值男性(0.774±0.200)分，女性(0.721±0.205)分，男性高于女性(t=7.500, P＜0.001)；老年人“疼痛不适”维度存在困难比例最高；总体生命质量拐点年龄男性72.5岁，女性70.5岁；Logistic回归分析模型结果表明拐点年龄对生命质量转变具有预测价值。结论安徽省农村地区老年人男性生命质量优于女性，女性生命质量拐点年龄早于男性。应关注老年人慢性疼痛及心理健康问题，以此提高生命质量。
- 农村地区 /
- 老年人 /
- 生命质量 /
- ROC曲线 /
- 拐点年龄
Abstract: Objective To evaluate the quality of life of the elderly in rural areas of Anhui Province and the gender differences of their inflection point age, to provide a reference for improving the quality of life of the elderly in rural areas. Methods A total of 3 336 older adults were investigated in 18 villages in Anhui Province by using a multistage stratified cluster random sampling method. The quality of life of the elderly was assessed by the five-dimensional European quality of health scale (EQ-5D), and the inflection point age of quality of life of the elderly in different genders was predicted by the receiver operator characteristic (ROC) curve. A binary Logistic regression analysis model was used to verify the predictive ability of inflection point age on quality of life. Results The health utility value of men was (0.774±0.200) and that of women was (0.721±0.205), which was higher in men than in women (t=7.500, P < 0.001); Whether male or female, the proportion of difficulty in the dimension of "pain and discomfort" was the highest; The inflection point age of quality of life was 72.5 years for men and 70.5 years for women; Logistic regression analysis model showed that inflection point age had a predictive value for the change of quality of life. Conclusions The quality of life of the elderly men in rural areas of Anhui Province is better than that of women, and the inflection point age of all dimensions of the quality of life of women is earlier than that of men. We should pay attention to the chronic pain and mental health of the elderly to improve the quality of life.
- Rural area /
- The elderly /
- Quality of life /
- ROC curve /
- Inflection point age

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图 1 总体生命质量ROC曲线

Figure 1. The ROC curve of overall quality of life

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表 1 调查对象人口学特征及生命质量情况[n(%)]

Table 1. Demographic characteristics and the quality of life of respondents [n(%)]

变量	合计(N=3 336)	性别		χ²值	P值	变量	合计(N=3 336)	性别		χ²值	P值
变量	合计(N=3 336)	男(n=1 640)	女(n=1 696)	χ²值	P值	变量	合计(N=3 336)	男(n=1 640)	女(n=1 696)	χ²值	P值
地域				1.632	0.442	行动能力				38.941	＜0.001
皖北	1 482(44.4)	716(43.7)	766(45.2)			有困难	1 484(44.5)	640(39.02)	844(49.76)
皖中	919(27.6)	448(27.3)	471(27.8)			无困难	1 852(55.5)	1 000(60.98)	852(50.24)
皖南	935(28.0)	476(29.0)	459(27.0)			自我照顾				15.123	＜0.001
贫困情况				14.117	＜0.001	有困难	652(19.5)	276(16.83)	376(22.17)
贫困户	1 206(36.2)	645(39.3)	561(33.1)			无困难	2 684(80.5)	1 364(83.17)	1 320(77.83)
非贫困户	2 130(63.8)	995(60.7)	1 135(66.9)			日常活动				22.808	＜0.001
慢性病种数				31.434	＜0.001	有困难	1 674(50.2)	754(45.98)	920(54.25)
0	865(25.9)	473(28.8)	392(23.1)			无困难	1 662(49.8)	886(54.02)	776(45.75)
1	1 227(36.8)	631(38.5)	596(35.1)			疼痛不适				58.555	＜0.001
≥2	1 244(37.3)	536(32.7)	708(41.8)			有困难	2 245(67.3)	1 000(60.98)	1 245(73.41)
文化程度				512.18	＜0.001	无困难	1 091(32.7)	640(39.02)	451(26.59)
文盲及半文盲	2 211(66.3)	778(47.4)	1 433(84.5)			焦虑抑郁				54.234	＜0.001
小学及以上	1 124(33.7)	862(52.6)	262(15.5)			有困难	1 295(38.8)	533(32.50)	762(44.93)
居住情况				2.576	0.059	无困难	2 041(61.2)	1 107(67.50)	934(55.07)
独居	660(19.8)	306(18.7)	354(20.9)			总体生命质量				21.398	＜0.001
非独居	2 676(80.2)	1 334(81.3)	1 342(79.1)			严重状态	524(15.7)	209(12.7)	315(18.6)
工作状态				62.534	＜0.001	普通状态	2 812(84.3)	1 431(87.3)	1 381(81.4)
工作	1 199(35.9)	699(42.6)	500(29.5)
不工作	2 137(64.1)	941(57.4)	1 196(70.5)

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表 2 调查对象生命质量评价维度拐点年龄(岁)

Table 2. Inflection point age of QOL evaluation dimension of respondents (years)

维度	AUC(95% CI)值	敏感度	特异度	最大约登指数	拐点年龄(岁)
行动能力
男	0.640(0.612~0.668)	0.439	0.777	0.216	74.5
女	0.670(0.644~0.695)	0.601	0.671	0.272	70.5
自我照顾
男	0.655(0.619~0.692)	0.591	0.645	0.236	72.5
女	0.660(0.628~0.692)	0.646	0.588	0.234	70.5
日常活动
男	0.636(0.609~0.663)	0.558	0.649	0.207	71.5
女	0.661(0.635~0.687)	0.573	0.665	0.238	70.5
疼痛不适
男	0.536(0.507~0.564)	0.336	0.738	0.074	74.5
女	0.570(0.539~0.601)	0.494	0.619	0.113	70.5
焦虑抑郁
男	0.538(0.508~0.568)	0.445	0.630	0.075	72.5
女	0.540(0.512~0.567)	0.768	0.304	0.072	65.5
总体生命质量
男	0.654(0.613~0.696)	0.598	0.635	0.233	72.5
女	0.664(0.630~0.697)	0.657	0.580	0.237	70.5

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表 3 Logistic回归模型对拐点年龄的验证

Table 3. Verification of inflection point age by Logistic regression model

维度	男性		女性
维度	OR(95% CI)值	C(95% CI)指数	OR(95% CI)值	C(95% CI)指数
行动能力	2.106(1.661~2.672)	0.727(0.702~0.752)	2.417(1.945~3.005)	0.732(0.708~0.755)
自我照顾	1.750(1.309~2.339)	0.716(0.690~0.741)	1.990(1.537~2.576)	0.721(0.694~0.749)
日常活动	1.810(1.450~2.259)	0.722(0.697~0.747)	2.060(1.661~2.554)	0.699(0.674~0.723)
疼痛不适	1.299(1.024~1.649)	0.653(0.627~0.680)	1.318(1.037~1.675)	0.672(0.643~0.701)
焦虑抑郁	1.332(1.070~1.658)	0.644(0.615~0.672)	1.272(1.010~1.601)	0.638(0.612~0.664)
总体生命质量	1.766(1.274~2.448)	0.786(0.753~0.819)	2.034(1.540~2.687)	0.739(0.711~0.767)

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