摘要
目的 了解中国老年人群衰老指数与身体活动对全因死亡的影响,为老龄化背景下制定积极老龄化政策提供依据。方法 数据来源于2014年和2018年中国老年健康影响因素追踪调查(CLHLS),最终纳入3 642名65岁及以上的老年人作为调查对象。采用问卷调查收集调查对象的人口统计学信息、生活方式与行为、认知功能、基本日常生活活动能力(BADL)、慢性疾病等信息,并通过死亡问卷收集死亡信息。采用R 4.0.5软件进行t检验、χ2检验。采用Cox比例风险模型分析4种衰老表型和衰老程度综合评分与老年人全因死亡的风险关联,并探索衰老与身体活动对死亡的联合作用。结果 随访期间共有1 156人死亡,死亡率为31.7%。多因素调整后,认知功能损失(HR=1.29,95%CI:1.12~1.48)、驼背(HR=1.32,95%CI:1.17~1.91)、慢病共患病(HR=1.33,95%CI:1.14~1.56)和BADL受损(HR=1.66,95%CI:1.44~1.91)均会增加老年人全因死亡风险。老年人死亡风险随着衰老程度综合评分增加呈上升趋势(1~5、6~10、11~15、16~21分HR分别为1.39、1.88、2.45和2.83,P<0.01)。参加身体活动可以降低老年人全因死亡风险(HR=0.67,95%CI:0.58~0.77)。身体活动与衰老表型之间存在相加交互作用,不参加身体活动和衰老表型同时存在时的死亡风险是它们单独存在时的风险值之和的1.41倍[相对超额危险度(RERI)=0.49,95%CI:0.07~0.90]。结论 老年人衰老表型对死亡有重大影响,参与身体活动对提高老年人期望寿命有重要意义。在老龄化背景下,通过控制衰老有关风险因素,并提倡健康的生活方式有助于实现积极老龄化。
Objective To study the influence of aging index and physical activity on all-cause mortality in the Chinese elderly,and provide the basis for active aging policies in the context of population aging. Methods The data were from Chinese Longitudinal Healthy Longevity Survey(CLHLS) in 2014 and 2018,finally 3 642 residents (≥65 years old) were included as the subjects. The investigation was performed with questionnaire(including demographic characters,lifestyle and behaviour,cognitive function,basic activities of daily living and chronic diseases),the death information was collected by death questionnaire. The t test and χ2test were used to analyze the data. Cox proportional risk models were used to analyze the relationship between the four aging phenotypes or aging scores and the risk of all-cause mortality in the elderly. Also the combined effects between aging and physical activity were explored. The used software was R 4.0.5. Results During the follow-up period,1 156 subjects died,the mortality was31.7%. After adjusting all confound factors,the cognitive impairment(HR=1.29,95%CI:1.12-1.48),hunchback(HR=1.32,95%CI:1.17-1.91),multi-morbidity of chronic diseases(HR=1.33,95%CI:1.14-1.56) and impaired basic activities of daily living(HR=1.66,95%CI:1.44-1.91) could increased the risk of all-cause mortality in the elderly.The elderly death risk increased with elderly comprehensive aging scores(HR values of 1-5,6-10,11-15,16-21 score groups were 1.39,1.88,2.45,and 2.83,respectively,P<0.01).The physical activity could reduce the risk of all-cause mortality(HR=0.67,95%CI:0.58-0.77).There was the interaction effects between physical activity and aging. The risk of death in the physical inactive combined aging was 1.41 times as compared with the sum of single effect(the relative excess risk ratio was 0.49,95%CI:0.07-0.90). Conclusion The aging phenotype in older adults has a significant impact on all-cause mortality,and physical activity participation has the important significance for increasing life expectancy in older adults.In aging context,controlling the risk factors related to aging and promoting a healthy life-style can improve the active aging.
作者
徐富升
刘建康
蔺婧
侯亚冰
张梦楠
马悦
杨洪喜
王耀刚
XU Fu-sheng;LIU Jian-kang;LIN Jing;HOU Ya-bing;ZHANG Meng-nan;MA Yue;YANG Hong-xi;WANG Yao-gang(School of Public Health,Tianjin Medical University,Tianjin 300070,China;不详)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2022年第4期241-245,共5页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
国家自然科学基金项目(91746205,71910107004)。
关键词
衰老
身体活动
认知功能
疾病共患
全因死亡
Aging
Physical activity
Cognitive function
Multi-morbidity
All-cause mortality
