中老年人生命历程中的社会经济状态与移动能力受限轨迹之间的关系  

Relationship between socioeconomic status and restricted mobility trajectory in the life course of middle-aged and elderly people

作　　者：齐丹丹 梁肖 宁镇廉 乔明亮[3] 孟毅[3] QI Dandan;LIANG Xiao;NING Zhenlian;QIAO Mingliang;MENG Yi(The Second Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou,Henan 450002,China;不详)

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450002 [2]郑州大学第三附属医院院长办公室,河南郑州450014 [3]河南省中医院老年病科,河南郑州450002

出　　处：《中华全科医学》2025年第4期685-690,共6页Chinese Journal of General Practice

基　　金：河南省中医药专项研究课题(2021JDZX2041,2021JDZX2111)。

摘　　要：目的通过评估生命历程中社会经济状态与移动能力受限轨迹之间的关系,为确定中老年人群晚期生活质量的风险因素提供证据支持。方法基于中国健康与养老追踪调查数据,纳入第3次随访并至少观察到2次移动能力受限的7714名受试者,采用基于群组的轨迹模型探索移动能力受限的最佳轨迹组别;采用多项logistic回归模型评估每个随访者的社会经济状态、生命历程中社会经济状态(SES)轨迹与移动能力受限轨迹的关联。采用中介效应分析探究成年社会经济状态(ASE)在儿童期社会经济状态(CSE)与移动能力受限轨迹组别关联中的中介效应。结果通过对受试者的分析,参与者在童年或成年时期经历了低水平的社会经济地位,则有较高的风险发展为移动能力受限较差的轨迹组。与高-高SES相比,高-低SES和低-低SES均分别与持续性中等以及递增至高的移动能力受限轨迹风险增加有关,且这两个时期累积暴露于不良SES的风险最大。此外,ASE对CSE与持续中轨迹组或递增至高轨迹组之间的关联具有显著的间接影响,移动能力受限轨迹与CSE之间的相关性可达13.68%~35.90%。结论通过干预儿童期和成年期社会经济状态的暴露水平,可以有效降低晚年移动能力受限的发生风险。Objective To evaluate the association between socioeconomic status and the trajectory of mobility limitation over the life course,and to provide evidence to support the identification of risk factors for late quality of life in middle-aged and older adults.Methods Based on the China Health and Retirement Tracking Survey(CHARLS)data,into the third followed up and observed at least twice limited mobility of 7714 subjects,the trajectory model based on group to explore mobile capacity constrained optimal trajectory group.Multinomial logistic regression models were used to assess the socioeconomic status of each follow-up and the association between socioeconomic status(SES)trajectories over the life course and mobility limitation trajectories.Mediating effect analysis was used to explore the mediating effect of adult socioeconomic status(ASE)on the association between childhood socioeconomic status(CSE)and the trajectory of mobility limitation.Results The participants with low SES in childhood or adulthood were at higher risk of developing into the poor mobility limitation trajectory group.Compared with high-high SES,high-low SES and low-low SES were both associated with an increased risk of persistent moderate and increasing to high mobility limitation trajectories,respectively,and the cumulative risk of exposure to adverse SES was greatest during these two periods.In addition,ASE had a significant indirect effect on the association between CSE and the persistent trajectory group or the increasing trajectory group,and the correlation between the mobility limitation trajectory and CSE could reach 13.68%-35.90%.Conclusion Intervention in socioeconomic status exposure in childhood and adulthood can effectively reduce the risk of mobility limitations in later life.

关 键 词：群组轨迹模型 社会经济学 生命历程 中介效应分析 中老年人 移动受限 

分 类 号：R592[医药卫生—老年医学]