基于功能状况探索老年人主动健康生活指数  

The exploration of the significance of proactive healthy living index for the elderly based on the functional capacity of Chinese older people

作　　者：张桂芳 韩怡文[1] 张驰[1] 庞婧[1] 宫环[1] 黎健[1] 张铁梅[1] 曾平[1] Zhang Guifang;Han Yiwen;Zhang Chi;Pang Jing;Gong Huan;Li Jian;Zhang Tiemei;Zeng Ping(The Key Laboratory of Geriatrics,Beijing Institute of Geriatrics,Beijing Hospital,National Center of Gerontology,National Health Commission Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100073,China)

机构地区：[1]北京医院,国家老年医学中心,国家卫生健康委北京老年医学研究所,国家卫生健康委北京老年医学重点实验室,中国医学科学院老年医学研究院,北京100073

出　　处：《中华老年医学杂志》2022年第6期714-719,共6页Chinese Journal of Geriatrics

基　　金：北京协和医学院2019年学科建设项目(201920202102);卫生部卫生行业科研专项基金(201302008);中央高校基本科研业务费项目(3332021077)。

摘　　要：目的探索老年人主动健康生活指数(PHLI)的意义,为老年人通过良好的日常生活习惯维持功能提供参考。方法基于步速和认知能力定义老年人功能状况,采用Logistic回归模型筛选可能影响功能状况的日常生活指标并绘制列线图进行可视化,根据列线图结果形成PHLI,以老年人功能状况是否正常为依据进行受试者工作特征曲线(ROC)分析,以灵敏度与特异度之和最大原则确定PHLI的界值。结果横断面研究,共纳入4971例老年人,年龄60~98(70.9±7.5)岁,其中53.3%(2649例)的老年人维持着正常功能状况。Logistic回归分析结果显示,家务劳动对老年人功能状态的影响最为显著、其次为正向心理(OR=2.04、1.92,均P<0.001),分别使老年人维持功能正常的可能性增加104%和92%;生活规律、充足蛋白摄入、睡眠质量等也是老年人功能状态正常的影响因素(均P<0.05)。纳入研究的老年人PHLI中位得分为7.3(5.9,8.3)分,ROC下面积(AUC)为0.70(95%CI:0.68~0.71),PHLI界值为6.8分。结论PHLI与老年人维持功能状况相关,可作为一个简易评估工具,为老年人采用积极主动的健康生活方式保持良好功能状况提供参考。Objective To explore the significance of proactive healthy living index(PHLI)to provide a reference for the elderly to maintain function through healthy daily life.Methods The functional status of the elderly was defined based on gait speed and cognitive function.Logistic regression model was used to select the daily life indicators which could be the risk factors for the functional status,and a nomogram was graphed for its visualization.PHLI was formed according to the result of the nomogram.Receiver operating characteristic curve(ROC)was plotted according to the functional status of the elderly,and the cut-off value of PHLI was determined based on the principle of the maximum sum of sensitivity and specificity.Results A total of 4971 participants with an average age of(70.9±7.5)years were included in the cross-sectional study,of whom 2649 cases(53.3%)maintained normal function.The Logistic regression analysis showed that the housework had the most significant effect on the functional status of the elderly,followed by positive psychology(OR=2.04,1.92;both P<0.001),increasing the likelihood of maintaining normal function by 104%and 92%,respectively.Regular life patterns,adequate protein intake,sleep quality and so on also influenced functional status of the elderly(all P<0.05).The PHLI median score of the elderly was 7.3(5.9,8.3)points.The area under the curve(AUC)was 0.70(95%CI:0.68-0.71),and the cut off value of PHLI was 6.8 points.Conclusions The PHLI is associated with the maintenance of functional capacity in the elderly,which can be applied as a simple tool to provide reference for old people to keep functional health through living a proactive healthy daily life.

关 键 词：健康状况指标 认知 步速 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]