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经历生命早期丧亲对中国老年人寿命影响研究

沈文达 张旭熙 孙昕霙 冯星淋 曾毅

沈文达, 张旭熙, 孙昕霙, 冯星淋, 曾毅. 经历生命早期丧亲对中国老年人寿命影响研究[J]. 中华疾病控制杂志, 2024, 28(9): 999-1004. doi: 10.16462/j.cnki.zhjbkz.2024.09.002
引用本文: 沈文达, 张旭熙, 孙昕霙, 冯星淋, 曾毅. 经历生命早期丧亲对中国老年人寿命影响研究[J]. 中华疾病控制杂志, 2024, 28(9): 999-1004. doi: 10.16462/j.cnki.zhjbkz.2024.09.002
SHEN Wenda, ZHANG Xuxi, SUN Xinying, FENG Xinglin, ZENG Yi. Study of the impact of experiencing early parental death on the lifespan of the elderly in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 999-1004. doi: 10.16462/j.cnki.zhjbkz.2024.09.002
Citation: SHEN Wenda, ZHANG Xuxi, SUN Xinying, FENG Xinglin, ZENG Yi. Study of the impact of experiencing early parental death on the lifespan of the elderly in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 999-1004. doi: 10.16462/j.cnki.zhjbkz.2024.09.002

经历生命早期丧亲对中国老年人寿命影响研究

doi: 10.16462/j.cnki.zhjbkz.2024.09.002
基金项目: 

科技部国家重点研发计划 2022YFC3600904

国家自然科学基金 72061137004

天津市医学重点学科(专科)建设项目流行病学-非传染病预防与控制 TJYXZDXK-051A

天津市卫生健康委重点学科专项 TJWJ2023XK028

详细信息
    通讯作者:

    孙昕霙,E-mail:xysun@bjmu.edu.cn

  • 中图分类号: R195.3

Study of the impact of experiencing early parental death on the lifespan of the elderly in China

Funds: 

National Key Research and Development Program of China 2022YFC3600904

National Natural Science Foundation of China 72061137004

Tianjin Key Medical Discipline (Specialty) Construction Project TJYXZDXK-051A

Special Project for Key Discipline of Tianjin Health Commission TJWJ2023XK028

More Information
  • 摘要:   目的  探索经历生命早期丧亲(即父亲或母亲死亡)事件对中国老年人寿命的影响。  方法  使用中国老年健康影响因素跟踪调查(Chinese longitudinal healthy longevity survey, CLHLS)2002―2021年数据,获取个体死亡或失访结局信息和早期丧亲状况等变量信息。组间比较使用χ2检验,单因素生存分析采用Kaplan-Meier法,多因素生存分析使用加速失效时间模型(accelerated failure time model, AFT),以时间比(time ratio, TR)表示发生风险。敏感性分析采用多重线性回归。  结果  追踪收集10 278名研究对象的生存数据,最终死亡7 738人,平均死亡年龄为(92.49±9.35)岁,存活358人,失访2 182人。通过Log-rank检验得出P=0.002,非早期丧亲中位生存时间为95岁(95% CI: 94.654~95.346),早期丧亲中位生存时间为94岁(95% CI: 93.494~94.506),差异有统计学意义(χ2 =9.404, P=0.002)。纳入控制变量,通过加速失效时间模型分析,经历早期丧亲者平均寿命是非早期丧亲者的0.994 2(95% CI: 0.990 3~0.998 2, P=0.004),即经历早期丧亲平均会缩短0.58%的个体寿命。  结论  经历早期丧亲事件会导致寿命缩短,应将早期丧亲作为危险因素加以研究和干预,缩小健康差异,提升国民健康水平。
  • 表  1  早期丧亲和非早期丧亲老年人基线情况

    Table  1.   Baseline characteristics of the elderly with early parental and non-early parental death

    变量
    Variable
    样本人数Sample size(n=10 278) χ2
    value
    P
    value
    非早期丧亲
    No-early parental death
    早期丧亲
    Early parental death
    性别Gender 0.551 0.458
      男性Male 3 317(69.9) 1 425(30.1)
      女性Female 3 835(69.3) 1 701(30.7)
    民族Ethnicity 1.489 0.222
      汉族Han 6 754(69.7) 2 933(30.3)
      少数民族Minority 398(67.3) 193(32.7)
    出生地Birthplace 2.235 0.135
      城市Urban 1 055(68.0) 497(32.0)
      农村Rural 6 097(69.9) 2 629(30.1)
    婚姻状况Marital status 0.550 0.459
      在婚In marriage 2 342(69.1) 1 047(30.9)
      非在婚Non-married 4 810(69.8) 2 079(30.2)
    是否有子女Status of children 1.223 0.269
      是Yes 6 885(69.7) 2 995(30.3)
      否No 267(67.1) 131(32.9)
    注:①以人数(占比/%)表示。
    Note: ① Number of people (proportion/%).
    下载: 导出CSV

    表  2  2002―2005年早期丧亲和非早期丧亲老年人直接死因分布情况

    Table  2.   Distribution of direct causes of death among the elderly with early parental and non-early parental death, 2002-2005

    遗传相关性
    Genetic correlation
    直接死因
    Direct causes of death
    死亡人数Number of death(n=5 031) χ2
    value
    P
    value
    非早期丧亲
    No-early parental death
    早期丧亲
    Early parental death
    遗传相关死因Genetically related causes of death 恶性肿瘤Malignant tumor 51(4.4) 186(4.8) 6.113 0.910
    心血管病Cardiovascular disease 94(8.2) 342(8.8)
    心脏病Heart disease 93(8.1) 265(6.8)
    呼吸系统疾病Respiratory diseases 84(7.3) 264(6.8)
    内分泌、营养、代谢或免疫性疾病Endocrine, nutritional, metabolic or immune diseases 31(2.7) 115(3.0)
    泌尿或生殖系统疾病Diseases of urinary or reproductive system 8(0.7) 25(0.6)
    痴呆或精神病Dementia or psychosis 1(0.1) 12(0.3)
    消化系统疾病Digestive system diseases 31(2.7) 113(2.9)
    非遗传相关死因Non-genetically related causes of death 意外Accident 57(5.0) 213(5.5)
    伤害或中毒Injury or poisoning 9(0.8) 35(0.9)
    结核病Tuberculosis 7(0.6) 28(0.7)
    其他Others 其他Other 672(58.5) 2 245(57.8)
    不知道Don′t know 10(0.9) 40(1.1)
    合计Total 1 148 3 883
    注:①以人数(占比/%)表示。
    Note: ① Number of people (proportion/%).
    下载: 导出CSV

    表  3  早期丧亲事件对我国老年人寿命影响的AFT分析结果

    Table  3.   Results of AFT analysis of the impact of early parental death on the life span of the elderly in China

    变量
    Variable
    人数
    Number of people
    (n=10 278)
    模型1 Model 1 模型2 Model 2 模型3 Model 3
    TR值value
    (95% CI)
    P
    value
    TR值value
    (95% CI)
    P
    value
    TR值value
    (95% CI)
    P
    value
    丧亲情况Status of early parental death
      非早期丧亲Non-early parental death 7 152 1.000 0 1.000 0 1.000 0
      早期丧亲Early parental death 3 126 0.993 6(0.989 9~0.997 4) 0.001 0.993 7(0.989 9~0.997 4) 0.001 0.994 2(0.990 3~0.998 2) 0.004
    性别Gender
      女性Female 5 536 1.000 0 1.000 0 1.000 0
      男性Male 4 742 0.993 9(0.989 6~0.998 2) 0.006 0.994 0(0.989 7~0.998 2) 0.006 1.000 5(0.995 6~1.005 4) 0.851
    现住城乡Current residence
      农村Rural 5 786 1.000 0 1.000 0 1.000 0
      城市Urban 4 492 1.011 9(1.008 0~1.015 6) < 0.001 1.011 9(1.008 0~1.016 0) < 0.001 1.014 5(1.010 2~1.018 8) < 0.001
    居住方式Residential mode
      独居Living alone 1 342 1.000 0 1.000 0 1.000 0
      与家人居住Living with family 8 508 1.017 8(1.012 4~1.023 2) < 0.001 1.017 6(1.012 2~1.023 1) < 0.001 1.013 9(1.008 0~1.019 8) < 0.001
      养老院Nursing home 428 0.990 9(0.981 3~1.000 5) 0.060 0.990 8(0.981 2~1000 5) 0.062 0.991 6(0.981 5~1.001 9) 0.108
    婚姻状况Marital status
      非在婚Non-married 410 1.000 0 1.000 0 1.000 0
      在婚In marriage 3 389 0.976 1(0.966 6~0.985 8) < 0.001 0.976 0(0.966 5~0.985 7) < 0.001 0.985 7(0.975 8~0.996 2) 0.008
      丧偶Widowed 6 479 1.032 0(1.022 4~1.041 7) < 0.001 1.032 0(1.022 2~1.041 6) < 0.001 1.038 8(1.028 4~1.049 2) < 0.001
    子女状况Status of children
      未育子女Childless 398 1.000 0 1.000 0 1.000 0
      子女均存活All children survive 5 589 0.980 2(0.971 0~0.989 5) < 0.001 0.980 2(0.970 9~0.989 5) < 0.001 0.978 2(0.968 6~0.987 9) < 0.001
      有子女死亡Death of children 4 291 1.004 6(0.995 0~1.014 2) 0.352 1.004 4(0.995 0~1.014 1) 0.362 1.003 8(0.993 9~1.013 9) 0.450
    文化程度Education
      文盲Illiterate 6 010 1.000 0 1.000 0 1.000 0
      非文盲Literate 4 268 0.985 6(0.981 2~0.990 0) < 0.001 0.985 5(0.981 2~0.989 8) < 0.001 0.989 3(0.984 8~0.993 9) < 0.001
    儿童期挨饿情况Childhood hunger situation
      不挨饿Not going hungry 3 796 1.000 0 1.000 0
      挨饿Go hungry 6 482 0.996 7(0.992 9~1.000 5) 0.088 0.997 0(0.993 1~1.001 0) 0.141
    吸烟情况Smoking status
      从不吸烟Never 6 488 1.000 0
      仅过去吸烟Only past 1 724 0.990 0(0.984 6~0.995 5) < 0.001
      仅现在吸烟Only now 97 0.965 4(0.947 9~0.983 8)
      一直吸烟Always 1 969 0.973 1(0.967 9~0.978 4) < 0.001
    患高血压Hypertension
      否No 8 689 1.000 0
      是Yes 1 589 0.986 8(0.981 5~0.992 1) < 0.001
    代答情况Answered by help
      否No 6 553 1.000 0
      是Yes 3 725 1.047 3(1.043 1~1.051 6) < 0.001
    注:1. 模型1,控制变量纳入了性别、民族、区域、现住城乡、居住方式、婚姻状况、子女状况、文化程度、职业、主观收入水平和老年及时就医情况;模型2,在模型1的基础上增加出生地、儿童期及时就医情况和儿童期挨饿情况;模型3,在模型2基础上增加吸烟情况、经常饮酒情况、经常锻炼情况、患高血压、患糖尿病、患心脏病、患脑卒中、患恶性肿瘤、患肺部疾病和代答情况。表中展示部分控制变量。
    2. AFT, 加速失效时间模型; TR, 时间比。
    Note: 1. Model 1, controls for variables such as gender, ethnicity, region, residence, residential mode, marital status, children′s status, educational, occupation, subjective income level, and timely medical care for the elderly; Model 2, adds variables such as birthplace, timely medical care during childhood, and childhood hunger situation on the basis of model 1; Model 3, adds variables such as smoking, regular alcohol consumption, regular exercise, hypertension, diabetes, heart disease, stroke, maligenant tumor, lung disease, and answered by help based on model 2. The table displays only part of the control variables.
    2. AFT, accelerated failure time model; TR, time ratio.
    下载: 导出CSV
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  • 收稿日期:  2023-12-06
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