中国老年人群工具性日常生活活动功能对自理能力受损的预测作用  

IADL as a Predictor of ADL Disability among the Chinese Elderly

作　　者：林威霞 宋新明[1] LIN Wei-xia;SONG Xin-ming

机构地区：[1]北京大学人口研究所,北京100871

出　　处：《残疾人研究》2022年第3期40-46,共7页Disability Research

基　　金：国家社会科学基金2017年度重大项目“健康预期寿命与人口群体健康水平测量”资助(17ZDA124)。

摘　　要：识别日常生活自理能力(ADL)受损高危人群并采取有效的干预措施,对于降低老年人ADL受损和照护依赖的发生风险具有重要意义。本研究采用队列研究方法,利用中国老年健康影响因素跟踪调查2005—2014年的四轮数据,构建了2005—2008年、2008—2011年和2011—2014年三个追踪样本,研究对象为基线调查时年龄≥65岁且尚未出现ADL受损、参与了基线调查三年后随访调查的老年人,旨在探索工具性日常生活活动(IADL)功能对于ADL受损的预测作用,为构建适用于中国老年人的ADL受损风险识别模型提供科学依据。三个追踪样本的多因素Logistic回归分析结果均显示,在控制社会人口学因素后,基线IADL受损越严重,随访时ADL受损的发生风险越高。基线IADL轻微受损、轻度受损、中度受损和重度受损的老年人,随访时ADL受损的发生风险分别是基线不存在IADL受损老年人的1.71—1.95倍、2.26—3.07倍、3.40—4.64倍和4.64—6.12倍。这一结果表明,IADL对ADL受损的发生具有良好的预测作用,对IADL的评估将有助于尽早识别ADL受损的高危人群并进行适当的干预。In recognition of the importance of reducing the risk of both ADL disability and dependency among the elderly,we need identify the high-risk population with ADL disability and take effective intervention measures. Based on prospective cohort study and using the data from the four waves of the Chinese Longitudinal Healthy Longevity Survey during 2005-2014, we established three cohorts including 2005-2008, 2008-2011 and 2011-2014 respectively. Our study population consisted of persons of 65 years of age or older who reported no ADL disability at baseline and completed follow-up interviews three years later. We aimed to explore the predictive effect of instrumental activities of daily living(IADL) on ADL disability, and then provide scientific basis for establishing risk identification model of ADL disability for Chinese elderly. We used multivariate logistic regression model and the results of three cohorts showed after controlling sociodemographic factors, the elderly with poor IADL at baseline were at higher risk for ADL disability. The elderly with slightly IADL impaired, mildly IADL impaired, moderately IADL impaired, and severely IADL impaired at baseline were 1.71-1.95 times, 2.26-3.07 times 3.40-4.64 times and 4.64-6.12 times as likely to have ADL disability as those without IADL impaired at baseline. This result showed that IADL is highly predictive of ADL disability and that assessment on IADL will help to identify the highrisk population with ADL disability as early as possible and then take effective intervention measures.

关 键 词：ADL IADL 风险识别 老年人 

分 类 号：G212.2[文化科学—新闻学]