中老年人社会隔离与脑卒中发病的关系  

The relationship of social isolation and stroke among the middle-aged and the elderly in China

作　　者：周鼒[1] 马佳平[1] 郝世超[1] 方亚[1] 

机构地区：[1]厦门大学公共卫生学院,福建厦门361102

出　　处：《中国老年学杂志》2016年第12期3027-3029,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(81573257);福建省自然科学基金(2014J05097);厦门市科技计划项目(3502Z20143006)

摘　　要：目的 探讨中老年人社会隔离与脑卒中发病的因果关系。方法 基于中国健康与养老追踪调查中2011和2013年两期的纵向调查资料,应用多重填补法处理缺失数据,以社会隔离作为暴露因素,使用χ^2检验比较2011年不同特征人群在随访结束时脑卒中发病率的差异,并采用边际结构模型分析社会隔离与脑卒中发病的因果关系。结果 共纳入研究对象8 768例。中老年人脑卒中发病率为0.8%,其中,社会隔离组的发病率为1.29%,非社会隔离组为0.72%。χ^2检验结果显示,脑卒中发病率在男性、60岁及以上、有吸烟史及患高血压、糖尿病或血脂异常的人群中较高（P〈0.05）;边际结构模型结果显示,社会隔离会增加脑卒中的发病风险（OR=1.91,P=0.037）。结论 社会隔离是中老年人脑卒中发病的重要危险因素。要树立中老年人的健康意识,维持良好的人际关系,鼓励参与社会组织及活动,改善社会隔离状态,以减少脑卒中的发生。Objective To examine the relationship between social isolation and stroke. Methods Data were derived from wave 2011 and wave 2013 of a national representative sample of people aged 45 or older from the China Health and Retirement Longitudinal Study （CHARI.S）. Missing data were dealed with Multiple Imputation Method. Social isolation was regarded as the exposure factor. Chi-square test was used to examine the differences of stroke morbidity among different characteristics of the respondents in wave 2011. Marginal Structural Model was applied to examine the relationship between social isolation and the risks of stroke. Results 8 768 individuals aged 45 or older were included. There were 70 new cases （ 0.8% ） of stroke occurred, and the stroke morbidity among social isolated was 1.29% and was 0.72% among not social isolated. Stroke morbidity among male, aged 60 or older, smoking history, hypertension, diabetes, and dyslipidemia were higher（ P〈0.05 ）. The results from marginal structural models showed that social isolation increased the risk of stroke （ OR = 1.91 ;P = 0. 037 ）. Conclusions Social isolation is a risk factor of stroke among middle-aged and older adults in China. They should be encouraged to participate more social organizations and social activities to improve their status of social isolation.

关 键 词：社会隔离 脑卒中 发病风险 边际结构模型 

分 类 号：R181.23[医药卫生—流行病学]