不同社会参与模式老年人的认知衰弱差异

韩佳滢; 巢健茜; 罗宗玉; 苏凡

doi:10.16462/j.cnki.zhjbkz.2023.09.012

不同社会参与模式老年人的认知衰弱差异

doi: 10.16462/j.cnki.zhjbkz.2023.09.012

韩佳滢^{1, 2},
巢健茜^{1, 2, ,},
罗宗玉^{1, 2},
苏凡^{1, 2}

1.
东南大学公共卫生学院医疗保险学系，南京 210009
2.
东南大学健康管理研究中心，南京 210009

基金项目:

江苏高校哲学社会科学研究重大项目 2022SJZD141

详细信息

通讯作者:
巢健茜，E-mail: chaoseu@163.com

中图分类号: R195
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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-10
- 修回日期: 2023-04-19
- 网络出版日期: 2023-10-12
- 刊出日期: 2023-09-10

A comparative study of differences in cognitive frailty in older adults with different social participation patterns

HAN Jiaying^{1, 2},
CHAO Jianqian^{1, 2
, ,},
LUO Zongyu^{1, 2},
SU Fan^{1, 2}

1.
Department of Medical Insurance, School of Public Health, Southeast University, Nanjing 210009, China
2.
Health Management Research Center, Southeast University, Nanjing 210009, China

Funds:

The Key Project of Philosophy and Social Science Research in Colleges and Universities in Jiangsu Province 2022SJZD141

More Information

Corresponding author: CHAO Jianqian, E-mail: chaoseu@163.com

摘要

摘要: 目的了解老年人认知衰弱现状，并探究不同社会参与模式老年人认知衰弱的差异和影响因素。方法利用2018年中国老年人健康影响因素跟踪调查数据，应用多因素非条件logistic回归分析模型和Fairlie分解法对老年人认知衰弱情况进行分析。结果 7 772名老年人中群体交往型老年人认知衰弱患病率为5.83%，自我消遣型老年人的认知衰弱患病率为21.53%，差异有统计学意义(χ²=426.10, P＜0.001)。多因素logistic回归分析模型分析结果显示，低龄、有教育背景、有配偶、较好的经济条件、饮酒、锻炼和有家庭支持是认知衰弱的保护因素。Fairlie分解结果显示，两种社会参与模式的健康差异中55.63%的部分是可由观测因素解释的，而44.37%的健康差异是两种模式本身造成的。结论群体交往型老年人认知衰弱情况好于自我消遣型老年人，应鼓励高龄老年人积极参与群体社会活动，加强锻炼，缩小健康差异。
- 认知衰弱 /
- 社会参与 /
- Fairlie分解法 /
- 老年人
Abstract: Objective To understand the current status of cognitive frailty in older adults, investigating the divergence in cognitive frailty and its contributing factors across various patterns of social participation. Methods Utilizing the 2018 Chinese longitudinal healthy longevity survey, we performed a multi-factor stepwise forward logistic regression analysis and Fairlie decomposition to discern the status of cognitive frailty in older adults. Results The prevalence of cognitive frailty among the 7 772 older adults was 5.83% for the group interaction type and 21.53% for the self-pastime type, with a statistically significant difference (χ²=426.10, P < 0.001). Multifactorial logistic regression results showed that low age, having an educational background, having a spouse, better economic conditions, alcohol drinking, exercising and having family support were protective factors for cognitive frailty. Fairlie decomposition results showed that 55.63% of the health differences between the two social participation patterns were explainable by observed factors, while 44.37% of the health differences were caused by the two patterns themselves. Conclusions The cognitive frailty status was better in group-interactive older adults than in self-pastime older adults. To mitigate health disparities, it is recommended that older adults are encouraged to actively engage in social activities and maintain regular exercise.
- Cognitive frailty /
- Social participation /
- Fairlie decomposition method /
- The elderly

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图 1 样本筛选流程图

Figure 1. Flow chart of sample screening

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表 1 不同特征老年人认知衰弱患病情况比较

Table 1. Comparison of the prevalence of cognitive frailty in older adults with different characteristics

变量Variable	合计Total (n=7 772)	无认知衰弱 Subjects without cognitivefrailty (n=6 954)	认知衰弱 Subjects with cognitivefrailty (n=818)	χ²值value	P值value
年龄组/岁Age group/years				381.09	< 0.001
65~＜80	3 212	3 134(45.07)	78(9.54)
≥80	4 560	3 820(54.93)	740(90.46)
性别Sex				84.63	< 0.001
男Male	3 602	3 347(48.13)	255(31.17)
女Female	4 170	3 607(51.87)	563(68.83)
教育背景Education background				265.27	< 0.001
有Yes	4 833	4 538(65.26)	295(36.06)
无No	2 939	2 416(34.74)	523(63.94)
婚姻状况Marital status				259.82	< 0.001
有配偶With spouse	3 635	3 470(49.90)	165(20.17)
无配偶Without spouse	4 137	3 484(50.10)	653(79.83)
经济状况Economic situation				43.31	< 0.001
较好good	6 989	6 307(90.70)	682(83.37)
较差poor	783	647(9.30)	136(16.63)
居住地Residency				0.18	0.674
城镇Urban	4 393	3 925(56.44)	468(57.21)
农村Rural	3 379	3 029(43.56)	350(42.79)
吸烟Smoking status				33.04	< 0.001
是Yes	1 268	1 192(17.14)	76(9.29)
否No	6 504	5 762(82.86)	742(90.71)
饮酒Alcohol drinking				39.36	< 0.001
是Yes	1 224	1 157(16.64)	67(8.19)
否No	6 548	5 797(83.36)	751(91.81)
锻炼Exercise				161.22	< 0.001
是Yes	2 748	2 623(37.72)	125(15.28)
否No	5 024	4 331(62.28)	693(84.72)
社会参与Social participation				426.10	< 0.001
群体交往型Group interaction type	5 450	5 132(73.80)	318(38.88)
自我消遣型Self-pastime type	2 322	1 822(26.20)	500(61.12)
注：①以[人数(占比/%)]表示。 Note: ① [Number of people (proportion/%)].

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表 2 不同社会参与模式老年人认知衰弱影响因素的多因素logistic回归分析

Table 2. Multifactorial logistic regression analysis of factors influencing cognitive frailty in older adults with different social participation patterns

变量Variable	对照组Control group	群体交往型Group interaction type
变量Variable	对照组Control group	β	s_x	Wald值value	OR值value(95% CI)	P值value
年龄组/岁Age group/years
≥80	65~＜80	1.359	0.170	64.168	3.892(2.791~5.427)	< 0.001
性别Sex
男Male	女Female	-	-	-	-	-
教育背景Education background
有Yes	无No	-0.663	0.125	28.147	0.515(0.403~0.658)	< 0.001
婚姻状况Marital status
有配偶With spouse	无配偶Without spouse	-0.388	0.146	7.054	0.678(0.509~0.903)	0.008
经济状况Economic situation
较好Good	较差Poor	-0.432	0.172	6.310	0.649(0.464~0.909)	0.012
饮酒Alcohol drinking
是Yes	否No	-0.394	0.195	4.076	0.675(0.460~0.989)	0.043
锻炼Exercise
是Yes	否No	-0.523	0.135	15.048	0.593(0.455~0.772)	< 0.001
家庭支持Family support
有Yes	无No	-0.569	0.143	15.718	0.566(0.427~0.750)	< 0.001
居住地Residency
城镇Urban	农村Rural	0.299	0.123	5.919	1.348(1.060~1.715)	0.015

变量Variable	对照组Control group	自我消遣型Self-pastime type
变量Variable	对照组Control group	β	s_x	Wald值value	OR值 value(95% CI)	P值value
年龄组/岁Age group/years
≥80	65~＜80	1.347	0.214	39.462	3.845(2.526~5.853)	< 0.001
性别Sex
男Male	女Female	-0.264	0.129	4.171	0.768(0.596~0.989)	0.041
教育背景Education background
有Yes	无No	-0.429	0.119	12.908	0.651(0.515~0.823)	< 0.001
婚姻状况Marital status
有配偶With spouse	无配偶Without spouse	-0.348	0.151	5.304	0.706(0.525~0.949)	0.021
经济状况Economic situation
较好Good	较差Poor	-0.544	0.153	12.627	0.580(0.430~0.784)	< 0.001
饮酒Alcohol drinking
是Yes	否No	-0.407	0.2	4.118	0.666(0.450~0.986)	0.042
锻炼Exercise
是Yes	否No	-0.909	0.181	25.152	0.403(0.282~0.575)	< 0.001
家庭支持Family support
有Yes	无No	-0.667	0.134	24.815	0.513(0.395~0.667)	< 0.001
居住地Residency
城镇Urban	农村Rural	-	-	-	-	-
注：“-”变量未纳入回归分析。 Note: "-" variable was not included the regression analysis.

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表 3 不同社会参与模式老年认知衰弱差异的Fairlie分解

Table 3. Fairlie decomposition of differences in cognitive frailty in older adults with different social participation patterns

变量Variable	对照组Control group	β	贡献率构成比/% Composition ratio of the contribution rate /%	P值 value
总差异Total differences		0.157	100.00
系数效应Coefficient effect		0.070	44.37
特征效应Characteristic effect		0.087	55.63
性别Sex
男Male	女Female	0.003	2.03	0.047
年龄组/岁Age group/years
≥80	65~＜80	0.031	20.01	< 0.001
教育背景Education background
有Yes	无No	0.011	6.73	< 0.001
婚姻状况Marital status
有配偶With spouse	无配偶Without spouse	0.006	4.09	0.024
经济状况Economic situation
较好Good	较差Poor	0.003	1.94	0.001
居住地Residency
城镇Urban	农村Rural	< 0.001	0.04	0.764
吸烟Smoking status
有Yes	无No	0.001	0.80	0.325
饮酒Alcohol drinking
有Yes	无No	0.002	1.36	0.076
锻炼Exercise
有Yes	无No	0.023	14.50	< 0.001
医疗服务可及性Accessibility of health services
有Yes	无No	0.001	0.53	0.321
家庭支持Family support
有Yes	无No	0.006	3.67	< 0.001

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