目的:调查内蒙古地区55岁及以上蒙、汉族中老年人群衰弱现状,分析其危险因素。方法:从内蒙古自治区55岁以上人群衰弱病例的数据集中随机选取407例无缺失值的数据为调查对象,运用多元线性回归,从该病例数据集中筛选出与衰弱相关性高的9个变量,并对病例衰弱程度利用1~6分打分制进行评定,采用多元线性回归分析与衰弱相关的危险因素。结果:回归分析结果显示,性别、婚姻、MMSE分数、有无职工保险、有无糖尿病、有无冠心病、有无骨关节炎、握力、每周锻炼次数会对老年衰弱产生较为明显的影响,均是内蒙古地区中老年人衰弱的影响因素(P < 0.05)。结论:内蒙古地区55岁以上蒙、汉族中老年人群中大部分人衰弱程度较低,健康的生活习惯对于中老年人减缓衰弱有明显作用。 Objective: To investigate the frailty status of Mongolian and Han middle-aged and elderly popula-tion aged 55 and above in Inner Mongolia and analyze its risk factors. Methods: From the Inner Mongolia autonomous region people over 55, 407 cases with no missing value data were randomly selected as investigation object, using multiple linear regression to screen out nine variables with high correlation with weak selection from the case data set, and the weak degree of cases was as-sessed using a scale of 1~6 points, using multiple linear regression to analyze risk factors associated with weakness. Results: The results of regression analysis showed that gender, marriage, MMSE score, employee insurance, diabetes, coronary heart disease, osteoarthritis, grip strength and weekly number of exercise had a significant impact on the frailty of the elderly in Inner Mongolia (P < 0.05). Conclusion: Most of the middle-aged and elderly people over 55 years old in Inner Mongolia have a low degree of asthenia, and healthy living habits have an obvious effect on slowing down as-thenia.
目的:调查内蒙古地区55岁及以上蒙、汉族中老年人群衰弱现状,分析其危险因素。方法:从内蒙古自治区55岁以上人群衰弱病例的数据集中随机选取407例无缺失值的数据为调查对象,运用多元线性回归,从该病例数据集中筛选出与衰弱相关性高的9个变量,并对病例衰弱程度利用1~6分打分制进行评定,采用多元线性回归分析与衰弱相关的危险因素。结果:回归分析结果显示,性别、婚姻、MMSE分数、有无职工保险、有无糖尿病、有无冠心病、有无骨关节炎、握力、每周锻炼次数会对老年衰弱产生较为明显的影响,均是内蒙古地区中老年人衰弱的影响因素(P < 0.05)。结论:内蒙古地区55岁以上蒙、汉族中老年人群中大部分人衰弱程度较低,健康的生活习惯对于中老年人减缓衰弱有明显作用。
衰弱,中老年,影响因素,蒙汉族
Hongyu Yan, Yifan Liu, Xueyi Yin, Xinyu Hu, Liang Liang*, Jiawen Yu, Jin Xu
Inner Mongolia University, Hohhot Inner Mongolia
Received: Dec. 1st, 2022; accepted: Dec. 29th, 2022; published: Jan. 6th, 2023
Objective: To investigate the frailty status of Mongolian and Han middle-aged and elderly population aged 55 and above in Inner Mongolia and analyze its risk factors. Methods: From the Inner Mongolia autonomous region people over 55, 407 cases with no missing value data were randomly selected as investigation object, using multiple linear regression to screen out nine variables with high correlation with weak selection from the case data set, and the weak degree of cases was assessed using a scale of 1~6 points, using multiple linear regression to analyze risk factors associated with weakness. Results: The results of regression analysis showed that gender, marriage, MMSE score, employee insurance, diabetes, coronary heart disease, osteoarthritis, grip strength and weekly number of exercise had a significant impact on the frailty of the elderly in Inner Mongolia (P < 0.05). Conclusion: Most of the middle-aged and elderly people over 55 years old in Inner Mongolia have a low degree of asthenia, and healthy living habits have an obvious effect on slowing down asthenia.
Keywords:Frailty, Middle-Aged and Old, Influencing Factors, The Han Nationality and Mongolian
Copyright © 2023 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
据统计,2019年世界65岁及以上的老年人口已经达到7.03亿,并预计这一数量将于2050年同比增长两倍之多 [
总体看,我国65岁老年人口规模和比重都在不断快速增加,无论是老年人口规模中每次突破1千万人口的年份间隔,还是老年人口比重每提升一个百分点的间隔年数,都越来越短,反映出老龄化快速的上升趋势 [
从内蒙古自治区55岁以上人群衰弱病例的数据集中随机选取407例无缺失值的数据为调查对象。
1) 年龄:≥55岁;2) 具有足够的理解能力与表达能力以配合完成本次研究;3) 常住居民(包括现有常住人口与暂时外出人口),过去12个月内,在当地累计居住6个月以上。
1) 年龄 < 55岁;2) 昏迷患者;3) 拒绝配合的患者。
运用多元线性回归,从该病例数据集中筛选出与衰弱相关性高的9个变量,包括性别、婚姻、简易智力状态检查量表(Mini-mental State Examination, MMSE)分数、职工保险、糖尿病、冠心病、骨关节炎、握力、目前锻炼。
1) MMSE分数分为正常(24~30分)和认知功能障碍(<24分,包括中学及以上21~24分、小学18~20分、文盲0~17分)两类 [
衰弱是一种临床综合征,其特征是生理储备功能减弱、多系统失调,使机体对应激和保持内环境稳定的能力下降,对应激事件的易感性增加,其计分范围1~6分。1) 1分表示脆弱易损伤,日常生活不需他人帮助,但身体的某些症状会限制日常活动,常见主诉为白天行动缓慢和感觉疲乏;2) 2分表示轻度衰弱,明显的动作缓慢,工具性日常工作活动需要帮助(如乘公交车、用药等),轻度衰弱会进一步削弱患者独自在外购物、行走及干家务活的能力;3) 3分表示中度衰弱,所有的室外活动均需要帮助,在室内上下楼梯、洗澡需要帮助,可能穿衣服也会需要(一定限度的)辅助;4) 4分表示严重衰弱,个人生活完全不能自理,但身体状态较稳定,一段时间内(<6个月)不会有死亡的危险;5) 5分表示非常严重的衰弱,生活完全不能自理,接近生命终点,已不能从任何疾病中恢复;6) 6分表示终末期,接近生命终点,生存期 < 6个月的垂危患者。
采用SPSS 21.0进行数据的分析处理建立数据库,录入数据,采用R 4.0.3软件对所得数据进行统计分析,采用多元线性回归分析与衰弱相关的危险因素。
1) 从内蒙古自治区55岁以上部分居民的各项统计数据经过回归分析后,性别、婚姻、MMSE分数、有无职工保险、有无糖尿病、有无冠心病、有无骨关节炎、握力、每周锻炼次数会对老年衰弱产生较为明显的影响。
2) 在本次研究所讨论的406例样本中,女性人数为178人,占比43.8%,男性人数228,占比56.2%,性别在衰弱问题上没有显著性差异。若以衰弱程度1、2、3作为衰弱前期,本次统计样本中共有295人处于此阶段,占比72.7%,表明55岁以上人群中大部分人衰弱程度较低。
3) 由回归分析结果可以得到婚姻、MMSE分数、有无职工保险、有无糖尿病、有无冠心病、有无骨关节炎、握力、每周锻炼次数均与老年衰弱有明显关联,其中每周锻炼次数的增多明显对衰弱有减缓作用,可见健康的生活习惯对于中老年人有非常大的好处;具有职工保险的人群各衰弱程度总人数明显少于无职工保险人群等。见表1。
衰弱程度 项目 | 分类 | 1 | 2 | 3 | 4 | 5 | 6 |
---|---|---|---|---|---|---|---|
性别 | 男 | 1 (16.7%) | 87 (48.6%) | 49 (44.56%) | 16 (30.77%) | 21 (48.84%) | 4 (25.00%) |
女 | 5 (83.3%) | 92 (51.4) | 61 (55.44%) | 36 (69.23%) | 22 (51.16%) | 12 (75.00%) | |
婚姻 | 1 | 0 | 3 (1.68%) | 3 (27.27%) | 0 | 1 (2.32%) | 0 |
2 | 6 (100%) | 159 (88.83%) | 86 (78.18%) | 42 (76.36%) | 34 (79.07%) | 8 (57.12%) | |
3 | 0 | 12 (6.70%) | 17 (15.45%) | 11 (20.0%) | 8 (18.60) | 5 (35.71%) | |
4 | 0 | 2 (1.12%) | 4 (3.63%) | 2 (3.63%) | 0 | 0 | |
5 | 0 | 2 (1.12%) | 0 | 0 | 0 | 1 (7.14%) | |
7 | 0 | 1 (0.56%) | 0 | 0 | 0 | 0 | |
MMSE分数 | <27 | 2 (33.33%) | 56 (31.28%) | 71 (64.55%) | 37 (67.27%) | 35 (81.40%) | 12 (85.71%) |
≥27 | 4 (66.67%) | 123 (68.17%) | 39 (35.45%) | 18 (32.73%) | 8 (18.60%) | 2 (14.29%) | |
职工保险 | 有 | 4 (66.67%) | 2 (33.33%) | 41 (37.27%) | 11 (20.00%) | 13 (30.23%) | 4 (28.57%) |
无 | 2 (33.33%) | 101 (56.42%) | 69 (67.73%) | 44 (80.00%) | 30 (69.77%) | 10 (71.43%) | |
糖尿病 | 有 | 6 (100.00%) | 155 (86.59%) | 86 (78.18%) | 40 (72.73%) | 37 (86.05%) | 7 (50.00%) |
无 | 0 | 24 (13.40%) | 24 (13.40%) | 15 (27.27%) | 6 (13.95%) | 7 (50.00%) | |
冠心病 | 有 | 5 (83.33%) | 155 (86.59%) | 84 (76.36%) | 37 (67.27%) | 29 (67.44%) | 8 (57.14%) |
无 | 1 (16.67%) | 24 (13.40%) | 26 (23.63%) | 18 (32.73%) | 14 (32.56%) | 6 (42.86%) | |
骨关节炎 | 有 | 6 (100%) | 7 (3.91%) | 103 (93.64%) | 48 (87.27%) | 37 (86.05%) | 13 (92.86%) |
无 | 0 | 172 (96.09%) | 7 (6.36%) | 7 (6.36%) | 6 (13.95%) | 1 (7.14%) | |
握力 | >36.255 | 1 (16.67%) | 16 (8.94%) | 10 (9.09%) | 3 (5.45%) | 1 (2.33%) | 0 |
(21.925, 36.225) | 4 (66.67%) | 79 (44.13%) | 38 (34.55%) | 15 (27.27%) | 17 (39.53%) | 2 (14.29%) | |
<21.925 | 1 (16.67%) | 84 (46.93%) | 62 (56.36%) | 37 (67.27%) | 25 (58.14%) | 12 (85.71%) | |
周锻炼次数 | 1 | 4 (66.67%) | 119 (66.48%) | 77 (70.00%) | 31 (56.36%) | 22 (51.16%) | 4 (25.00%) |
2 | 0 | 5 (2.79%) | 1 (0.90%) | 3 (5.45%) | 1 (2.33%) | 4 (25.00%) | |
3 | 1 (16.67%) | 12 (6.70%) | 6 (5.45%) | 0 | 1 (2.33%) | 0 | |
4 | 1 (16.67%) | 43 (24.02%) | 26 (23.63%) | 21 (38.18%) | 19 (44.17) | 8 (50.00%) |
表1. 蒙、汉族55岁以上人群衰弱多因素回归分析结果
本次研究结果显示,在已统计的内蒙古自治区55岁以上患有老年衰弱居民中,超过70%的居民仅处于衰弱前期,而由回归结果可以看到糖尿病、冠心病、骨关节炎等中老年人群常见疾病均与衰弱有较大关系,因各类疾病入院治疗的老年群体中衰弱率也相对较高 [
随着我国老龄化程度的不断加深,老年人群中经常出现的衰弱这一现象引起了相关研究人员的注意,但我国对于老年衰弱的研究还仅仅停留在初级阶段。根据国外调查数据显示,老年人群从65岁到80岁衰弱人数迅速上升,在我国平均寿命不断上升的情况下,老年衰弱的研究与防治迫在眉睫。老年衰弱成因复杂,本次研究仅对已收集数据进行大致分析,为本地区衰弱防治提供初步参考。衰弱对老年人正常生活影响较大,提前防治可有效减少由于衰弱带来的负面影响、提高老年人生活水平、降低老龄化社会对我国发展造成的影响。目前国内外缺乏对衰弱程度进行诊断的统一标准,主要还是依托于患者主观感受而缺乏客观度量,Frail量表为目前运用最广泛的判断标准,我国近年也建立了相关网站宣传、科普老年衰弱的相关信息,并且可以对老年人的衰弱情况进行简单测试 [
闫红宇,刘轶凡,尹雪怡,胡心宇,亮 亮,于佳文,徐 瑾. 内蒙古自治区55岁以上人群衰弱因素分析Analysis of Frailty Factors in People over 55 Years Old in Inner Mongolia Autonomous Region[J]. 临床医学进展, 2023, 13(01): 101-105. https://doi.org/10.12677/ACM.2023.131016