经历生命早期丧亲对中国老年人寿命影响研究  

Study of the impact of experiencing early parental death on the lifespan of the elderly in China

作　　者：沈文达 张旭熙[1,4] 孙昕霙 冯星淋[2] 曾毅 SHEN Wenda;ZHANG Xuxi;SUN Xinying;FENG Xinglin;ZENG Yi(Department of Social Medicine and Health Education,School of Public Health,Peking University,Beijing 100191,China;Department of Health Policy and Management,School of Public Health,Peking University,Beijing 100191,China;Center for Healthy Aging and Development Studies,National School of Development,Peking University,Beijing 100871,China;Center for Healthy Aging,Health Science Center,Peking University,Beijing 100191,China;Center for the Study of Aging and Human Development,Medical School of Duke University,Durham NC27710,USA;Institute of Non-communicable Disease Control and Prevention,Tianjin Centers for Diseases Control and Prevention,Tianjin 300011,China)

机构地区：[1]北京大学公共卫生学院社会医学与健康教育系,北京100191 [2]北京大学公共卫生学院卫生政策与管理学系,北京100191 [3]北京大学国家发展研究院健康老龄与发展研究中心,北京100871 [4]北京大学医学部老年健康研究中心,北京100191 [5]杜克大学医学院老龄与人类发展研究中心和老年医学部,达勒姆NC27710 [6]天津市疾病预防控制中心非传染性疾病预防控制所,天津300011

出　　处：《中华疾病控制杂志》2024年第9期999-1004,1022,共7页Chinese Journal of Disease Control & Prevention

基　　金：科技部国家重点研发计划(2022YFC3600904);国家自然科学基金(72061137004);天津市医学重点学科(专科)建设项目流行病学-非传染病预防与控制(TJYXZDXK-051A);天津市卫生健康委重点学科专项(TJWJ2023XK028)。

摘　　要：目的探索经历生命早期丧亲(即父亲或母亲死亡)事件对中国老年人寿命的影响。方法使用中国老年健康影响因素跟踪调查(Chinese longitudinal healthy longevity survey,CLHLS)2002―2021年数据,获取个体死亡或失访结局信息和早期丧亲状况等变量信息。组间比较使用χ^(2)检验,单因素生存分析采用Kaplan-Meier法,多因素生存分析使用加速失效时间模型(accelerated failure time model,AFT),以时间比(time ratio,TR)表示发生风险。敏感性分析采用多重线性回归。结果追踪收集10278名研究对象的生存数据,最终死亡7738人,平均死亡年龄为(92.49±9.35)岁,存活358人,失访2182人。通过Log-rank检验得出P=0.002,非早期丧亲中位生存时间为95岁(95%CI:94.654~95.346),早期丧亲中位生存时间为94岁(95%CI:93.494~94.506),差异有统计学意义(χ^(2)=9.404,P=0.002)。纳入控制变量,通过加速失效时间模型分析,经历早期丧亲者平均寿命是非早期丧亲者的0.9942(95%CI:0.9903~0.9982,P=0.004),即经历早期丧亲平均会缩短0.58%的个体寿命。结论经历早期丧亲事件会导致寿命缩短,应将早期丧亲作为危险因素加以研究和干预,缩小健康差异,提升国民健康水平。Objective To explore the impact of early parental death(i.e.,death of father or mother)on the life span of the elderly in China.Methods The tracking data from the Chinese longitudinal healthy longevity survey(CLHLS)from 2002 to 2021 were utilized to acquire information on individual mortality/loss to follow-up outcomes and variables such as early parental death.Differences between groups were assessed using theχ^(2)test.Univariate survival analysis employed the Kaplan-Meier method,while multivariate survival analysis employed the accelerated failure time model(AFT),with the risk of occurrence expressed as the time ratio(TR).Sensitivity analysis was conducted by multiple linear regression.Results A total of 10278 individuals were recruited as study participants,of whom 7738 passed away,with an average age of 92.49±9.35 years.358 survived and 2182 were lost to follow-up.The Kaplan-Meier analysis revealed a P-value of 0.002 and the median survival time for non-early parental death was 95 years old(95%CI:94.654-95.346)whereas the median survival time for early parental death was 94 years old(95%CI:93.494-94.506).with the difference was statistically significant.After adjusting for control variables,the AFT model analysis indicated that the average lifespan of those who had experienced early parental death was 0.9942 that of those who had not(95%CI:0.9903-0.9982,P=0.004),indicating that experiencing early parental death reduces an individual′s average lifespan by 0.58%.Conclusions Experiencing early parental death will lead to a shortened life span.It is necessary to study and intervene the early parental death as a risk factor,thereby narrowing the health gap and improving the national health level.

关 键 词：丧亲 老年人 寿命 加速失效时间模型 时间比 

分 类 号：R195.3[医药卫生—卫生统计学]