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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
传真:010-66936756
E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
景小凡,孙建琴,柳园,陈伟,李鸣,莫宝庆,万雪梅,黄承钰,杨珉.中国五城市老年人日常生活能力-失能危险因素分析[J].中华老年多器官疾病杂志,2017,16(12):884~888
中国五城市老年人日常生活能力-失能危险因素分析
Risk factors for activity of daily living-disability in the elderly living in 5 cities of China
投稿时间:2017-09-04  修订日期:2017-10-12
DOI:10.11915/j.issn.1671-5403.2017.12.206
中文关键词:  老年人;病例-对照研究;失能;简易微型营养评价表
英文关键词:aged; case-control study; disability; mini-nutritional assessment short form
基金项目:中国营养学会老年分会与雀巢营养科学院合作项目(C-00268016)
作者单位E-mail
景小凡 四川大学华西医院临床营养科,成都 610041  
孙建琴 复旦大学华东医院临床营养科,上海 200040  
柳园 四川大学华西医院临床营养科,成都 610041  
陈伟 北京协和医院肠内肠外营养科,北京 100730  
李鸣 四川大学华西公共卫生学院营养与食品卫生教研室,成都 610041  
莫宝庆 南京医科大学公共卫生学院营养与食品卫生教研室,南京 211166  
万雪梅 成都市晋阳卫生服务中心,成都 610045  
黄承钰 四川大学华西公共卫生学院营养与食品卫生教研室,成都 610041 hcynuph@163.com 
杨珉 西部农村卫生发展研究中心,成都 610041  
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中文摘要:
      目的 分析老年人日常生活能力(ADL)-失能的相关影响因素。方法 对上海、北京、广州、成都、重庆五城市养老院、社区卫生服务中心及综合医院3类机构中年龄≥65岁老年人进行调查。采用病例-对照研究,对调查对象进行面对面问卷调查和体格检查,内容包括ADL、健康和营养等方面。判断失能与营养评价分别采用ADL-Barthel指数评定量表和微型营养评定法简版(MNA-SF)。采用SPSS 16.0软件进行统计分析,组间比较采用χ2检验。多因素logistic回归分析老年人ADL-失能的影响因素。结果 最终4929人入选本研究,根据失能情况分为病例组(<20分,n=379)与对照组(≥60分,n=4550)。两组年龄、城市、机构、所患疾病(心脑血管系统疾病、消化系统疾病、呼吸系统疾病、泌尿系统疾病、骨骼系统疾病)差异均有统计学意义(P<0.05)。两组意识、呼吸、体温、水肿、黏膜、皮肤弹性、咀嚼能力及牙齿差异均有统计学意义(P<0.05)。所有入组者中,营养状况正常占50.90% (2509/4929),存在营养风险33.66%(1659/4929),营养不良15.44%(761/4929),两组营养状况差异具有统计学意义(P<0.001);多因素logistic分析显示,精神神经系统疾病(OR=3.41)、咀嚼功能较差(OR=2.03)、心血管系统疾病(OR=1.87)、>90岁(OR=1.84)、泌尿系统疾病(OR=1.55)是老年人AD-失能的危险因素;良好的营养状况(OR=0.73)和消化系统疾病(OR=0.51)是老年人AD-失能的保护因素。结论 >90岁、咀嚼功能差、营养不良、患有精神神经、心血管及泌尿等系统疾病的老年人ADL-失能的风险增大。
英文摘要:
      Objective To investigate the influencing factors for activity of daily living (ADL)-disability in the elderly. MethodsA case-control study was performed on the elderly subjects (over 65 years old) who came from nursing homes, community health centers and general hospitals in Beijing, Shanghai, Guangzhou, Chengdu, and Chongqing. Face-to-face questionnaires and physical examinations were conducted on the participants to survey their DLA, health and nutritional statuses. ADL-Barthel index and mini-nutritional assessment short form (MNA-SF) were used for assessment of disability and nutritional status. SPSS statistics 16.0 was used to perform the statistical analysis. Chi-square test was employed for intragroup comparison, and multivariate logistic regression analysis was adopted for the influencing factors for ADL-disability. Results A total of 4929 subjects were finally enrolled in this study, and according to disability condition, they were assigned into case group (<20 points, n=379) and control group (≥60 points,n=4450). Significant discrepancies were found in age, city, institution, and comorbidities (cardiovascular and cerebrovascular diseases, digestive diseases, respiratory diseases, urinary diseases, and skeletal diseases) between the 2 groups (P<0.05). There were obvious differences in consciousness, breath, temperature, edema, mocous membrane, skin elasticity, chewing ability and tooth (P<0.05). Among the all participants, 50.90% (2509/4929) were at adequate nutritional status, 33.66% (1659/4929) at risk of malnutrition, and 15.44% (761/4929) in malnutrition. Notable differences were also seen in the nutritional status between the 2 groups (P<0.001). Multivariate logistic regression analysis showed that mental and nervous diseases (OR=3.41), poor masticatory function (OR=2.03), cardiovascular diseases (OR=1.87), over 90 years old (OR=1.84) and urinary diseases (OR=1.55) were risk factors for ADL-disability, while adequate nutritional status (OR=0.73) and digestive diseases (OR=0.51) were the protective factors. Conclusion The elderly over 90 years old, with poor masticatory function, and suffering from mental and nervous diseases, cardiovascular diseases and urinary diseases are prone to ADL-disability.
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