中国高龄老人健康状况和死亡率变动趋势  

Trends of Disability and Mortality among the Oldest-Old in China

作　　者：曾毅[1,2,3,4] 冯秋石 Therese Hesketh Kaare Christensen James W.Vaupel Zeng Yi Feng Qiushi(Therese Hesketh Kaare Christensen James W. Vaupe)

机构地区：[1]北京大学国家发展研究院健康老龄与发展研究中心 [2]北京大学瑞意高等研究院 [3]美国杜克大学医学院老龄与人类发展研究中心 [4]美国杜克大学医学院老年医学部 [5]新加坡国立大学社会学系 [6]英国伦敦大学学院全球健康研究所 [7]浙江大学公共卫生学院全球健康研究所 [8]南丹麦大学公共健康研究所 [9]德国马普人口研究所

出　　处：《人口研究》2017年第4期22-32,共11页Population Research

基　　金：国家自然科学基金(71233001,71490732);NIA/NIH(2P01AG031719);联合国人口基金的联合资助

摘　　要：文章对"中国老年健康影响因素跟踪调查"近两万名80~105岁高龄老人的数据分析发现,社会经济发展使得2008年高龄老人存活概率和自评日常生活自理能力比1998年有显著改善。医疗条件进步使健康较差高龄老人被"救"存活率提高,使2008年高龄老人客观量测的躯体功能和认知功能比10年前显著下降;这给社会和亿万家庭带来严峻挑战。研究表明,经济社会发展和人类寿命提高带来效益的同时,也会产生一定成本;但它不是以往不少国际文献解释这一现象时所称的"胜利的失败",所以没有必要为此恐慌,而需要全社会积极应对,努力实现人口健康老龄化。Based on analyzing data of 19,528 oldest-old aged 80-105 from Chinese Longitudinal Healthy Longevity Study, we found that the age-specific mortality rates and disability in activities of daily living （ADL） were substantially reduced among oldest-old individuals in 2008 compared with 1998, which was due to rapid socioeconomic development. However, we also observed significant increase in disabilities of physical performance and cognitive capacity among the oldest-old during the same period over 1998-2008. This is because remarkable advancements in medical technology and living standards en- hanced longevity and ＂saved＂ quite a lot of frail elderly＇s lives and thus increased overall disability rates of physical and cognitive functions. We believe that the success of increasing human lifespan will come along with both benefits （ e. g. improvement in ADL） and costs （ e. g. worsened average physical and cognitive capacities） among the oldest-old. However, the costs may not be considered as ＂failure of success＂, that was widely used in connection with the theory of expansion of morbidity in the literature of population aging studies, because it sounds too pessimistic and may mislead the public. We propose to use ＂costs of success＂ and ＂benefits of success＂ to summarize the co-existence of expansion of morbidity and compression of morbidity, as discovered in present and other studies. We believe that the society does not need to be scared about the ＂costs of success＂, but rather try to face the challenges by sound policy actions to reduce the costs and increase the benefits of the success of longevity, and eventually achieve the goal of healthy aging.

关 键 词：高龄老人 生活自理能力 躯体功能 认知功能 健康老龄化 

分 类 号：C924.2[社会学—人口学] R161.7[医药卫生—公共卫生与预防医学]