我国老年人慢性病共病模式及健康管理策略建议  

Co-morbidity patterns of chronic diseases among the elderly in China and suggestions for health management strategies

作　　者：赵延芳 王雪飙 邹媛[1] 姚华[2] Zhao Yanfang;Wang Xuebiao;Zou Yuan;Yao Hua(School(Center)of Health Management,the First Affiliated Hospital of Xinjiang Medical University,Urumqi830011,China;Health Management Research Institute,the First Affiliated Hospital of Xinjiang Medical University,Urumqi830011,China)

机构地区：[1]新疆医科大学第一附属医院健康管理学院(中心),乌鲁木齐830011 [2]新疆医科大学第一附属医院健康管理研究所,乌鲁木齐830011

出　　处：《中华健康管理学杂志》2025年第1期8-13,共6页Chinese Journal of Health Management

基　　金：新疆维吾尔自治区创新环境(人才、基地)建设专项项目(PT2207)。

摘　　要：目的分析我国老年人慢性病共病模式,提供相关健康管理策略建议。方法本研究为横断面研究,选取2020年中国健康与养老追踪调查(CHARLS)数据集年龄≥60岁且关键变量(慢性病患病情况、年龄、性别、婚姻状态等)值完整的9383例调查对象作为研究对象。采用系统聚类分析城乡老年人共病模式,采用probit模型对共病患病风险进行相关性分析,提供相关健康管理策略建议。结果我国城乡老年人慢性病共病模式存在相同之处,一是情感及精神方面问题、帕金森症、癌症等恶性肿瘤为一类的精神心理和神经退行性疾病模式,二是中风、哮喘、肝脏疾病为一类的炎症反应疾病模式;但也存有差异,城市老年人血脂异常单独聚为一类,记忆相关的疾病与糖尿病或血糖升高、慢性肺部疾病及肾脏疾病聚为一类,农村老年人胃部疾病或消化系统疾病与记忆相关的疾病、糖尿病或血糖升高、慢性肺部疾病及肾脏疾病聚为一类。户籍所在地为农村(Z=-0.530)、重度体力活动(Z=-0.024)与共病患病风险呈负相关,年龄(Z=0.037)、饮酒(Z=0.037)、吸烟(Z=0.042)、抑郁评分(Z=0.130)、睡眠时长(Z=0.027)与共病患病风险呈正相关(均P<0.05),其中户籍所在地关联性最强,抑郁评分次之。结论我国老年人慢性病共病模式在城市和农村地区存在差异,建议根据城乡老年人慢性病共病的特点,制定有针对性的慢性病管理策略,有助于提高慢性病共病防治管理成效。ObjectiveTo analyze the co-morbidity patterns of chronic diseases among the elderly in China and provide suggestions for health management strategies.MethodsIt was a cross-sectional study.A total of 9383 respondents aged≥60 years with complete data of key variables(chronic disease status,age,gender,marital status,etc.)in the 2020 China Health and Aged Care Tracking Survey(CHARLS)dataset were selected as study subjects.Systematic clustering was used to analyze the pattern of multimorbidity among urban and rural elderly,and probit model was used to analyze the relevant factors associated with the risk of multimorbidity in order to provide suggestions for health management strategies.ResultsThere were similarities in the multimorbidity patterns of chronic diseases among the elderly in both urban and rural areas in China,including emotional and mental problems,Parkinson′s disease and malignant tumors such as cancer as a group of psychosomatic and neurodegenerative disease pattern,and stroke,asthma and liver disease as a group of inflammatory response disease pattern.However,there were differences,with dyslipidemia clustered as a separate group among the urban elderly,and memory-related diseases with diabetes or elevated blood glucose,chronic lung disease and kidney disease clustered as another group;and in rural elderly,gastric or digestive disorders were clustered with memory-related disorders,diabetes or elevated blood glucose,chronic lung disease,and kidney disease.Registered residence in rural areas(Z=-0.530),and heavy physical activity(Z=-0.024)were negatively with the risk of multimorbidity.Age(Z=0.037),alcohol consumption(Z=0.037),smoking(Z=0.042),depression score(Z=0.130),and length of sleep(Z=0.027)were positively correlated with the risk of multimorbidity(all P<0.05),with domicile location being the most strongly associated factor,and depression score being the second one.ConclusionThe pattern of chronic disease co-morbidity among the elderly in China differs between urban and rural areas.It is recommen

关 键 词：老年人 慢性病 共病模式 危险因素 健康管理 健康促进 

分 类 号：R47[医药卫生—护理学]