高龄与低龄老人失能影响因素及其防治重点  

The contributing risk factors, prevention and treatment of functional dependence among the oldest-old and elderly subjects

作　　者：刘殿荣[1] 谭纪萍[2] 郭雨禾[3] 叶光华 朱林奇 张军[6] 李英豪 邓玉成 王贵臣[5] 王鲁宁[1] 

机构地区：[1]解放军总医院,北京100853 [2]解放军总医院南楼神经内科,北京100853 [3]总后勤部卫生部保健局 [4]海军北京香山干休所 [5]北京军区政治部第四干休所 [6]北京军区司令部门诊部 [7]北京军区司令部第四干休所 [8]北京军区装备部干休所

出　　处：《中华内科杂志》2014年第10期772-777,共6页Chinese Journal of Internal Medicine

基　　金：解放军总后勤部卫生部保健专项科研课题（07BJZ04、10BJZ19、11BJZ09、12BJZ46）

摘　　要：目的 探讨80岁及以上高龄人群与低龄老人失能的相关影响因素及其防治重点.方法 调查驻京部队干休所60岁及以上离退休干部人口学信息、生活方式和业余活动及各系统慢性病史,以“日常生活能力20项版本”评价是否存在功能依赖.结果 认知障碍、锥体外系病、脑梗死、脑缺血发作、睡眠障碍、服用安眠药、骨关节病、高血压和跌倒为高龄老人功能依赖的独立危险因素,OR值在1.241 ～2.962（P值均＜0.05）;低龄老人功能依赖相关的危险因素依次为卒中、抑郁、认知障碍、锥体外系病、睡眠障碍、服用安眠药、跌倒、心血管病、骨关节病、听力障碍等,OR值在1.232～5.790（P值均＜0.05）.社会参与、体育锻炼、摄影、读书报、益智游戏等业余活动对低龄及高龄老人功能均具有保护意义,OR值为0.074 ～ 0.672（P值均＜0.05）.结论 神经精神疾病是导致低龄及高龄老人失能的首要慢性病,神经系统变性病为高龄老人首要的防治重点,低龄老人的防治重点为卒中和抑郁.健康的生活方式和丰富的业余活动是降低低龄及高龄老人失能的有效措施.Objective To compare the risk factors on the functional dependence between the oldest-old and elderly veterans.Methods A cross-sectional survey was conducted among veterans （≥60 years of age） lived in 44 veterans＇ communities in Beijing.The socio-demographic information and history of noncommunicable chronic diseases were collected via face-to-face interviews,and the functional status was assessed by the 20-item version of the Activities of Daily Living Scale.Results The risk factors associated with increased hazard of the functional dependence in the oldest-old （≥ 80 years old） were cognitive impairment,extrapyramidal diseases,cerebral infarction,transient ischemic attack,sleep disorders,hypnotics,osteoarthrosis,hypertension and fall with the odds ratio （OR） of 1.241-2.962 （all P 〈 0.05）.Stroke,depression,cognitive impairment,extrapyramidal diseases,sleep disorders,hypnotics,fall,cardiovascular diseases,osteoarthrosis and hearing loss were the risk factors for that in the elderly subjects （aged 60-79 years）.The OR was 1.232-5.790 （all P 〈 0.05）.However,avocational activities such as social activity,physical exercise,photography,reading and games,decreased the risk of functional dependence in both the oldest-old and elderly people.Conclusions Neuropsychiatric disorders are the leading causes contributed to the functional dependence among oldest-old and elderly population.Neurodegenerative diseases in the oldest-old,stroke and depression in elderly people should be the priorities in ameliorating disability.Healthy lifestyle and avocational activities could improve the functional status of the oldest-old and elderly population.

关 键 词：慢性病 危险因素 高龄老人 神经精神疾病 失能 

分 类 号：R473.5[医药卫生—护理学]