上海郊区某社区老年衰弱患病率及生活方式影响因素分析

黄建华 陈川 陈久林 潘丽红 宋海萍

摘 要 目的：分析上海郊區某社区老年衰弱患病率及生活方式影响因素，为社区老年衰弱防治提供依据。方法：在社区老年健康体检人群中，分级抽取527例60岁及以上老年人进行调查。年龄63～89岁，平均年龄为（71.70±5.75）岁;其中男性222人，平均年龄为（71.71±5.59）岁;女性305人，平均年龄为（71.69±5.87）岁。通过现场采集病史及Fried衰弱表型量表等信息，测定4米步速及握力，分析老年衰弱的患病率及影响因素。结果：社区老年衰弱患病率8.0%，男性患病率低于女性（3.2%比11.5%，P<0.01），女性老年人衰弱患病率随年龄增加而升高（P<0.01）。相较于无衰弱老人，衰弱前期、衰弱老人的年龄（P<0.01）和慢病数量增加（P<0.05）。文盲或半文盲、小学、初中文化老人衰弱患病率依次为12.5%、4.1%、1.7%（P<0.01）;丧偶老人患病率高于已婚老人（15.4%比6.5%，P<0.01）;独居老人患病率高于同住老人（15.2%比6.7%，P<0.01）。Logistic回归分析显示，女性、高龄、慢病数量是社区老年衰弱的危险因素，与人同住、多锻炼是保护因素。结论：上海郊区某社区老人衰弱患病率8.0%，性别、年龄、居住状况、锻炼次数和慢病数量是老年衰弱的影响因素。

关键词 老年衰弱;患病率;影响因素;Fried衰弱表型

中图分类号：R592 文献标志码：A 文章编号：1006-1533（2021）04-0033-04

Analysis of the prevalence of frailty and influencing factors of lifestyle in a community in the suburbs of Shanghai

HUANG Jianhua1， CHEN Chuan2， CHEN Jiulin2， PAN Lihong1， SONG Haiping1（1. General Practice Department of Situan Community Health Service Center of Fengxian District， Shanghai 201413， China; 2. Basic Research Office of Institute of Geriatrics of Traditional Chinese Medicine， Shanghai 200031， China）

ABSTRACT Objective： To analyze the prevalence of frailty and influencing factors of lifestyle in a community in the outer suburbs of Shanghai to provide evidence for the prevention and treatment of frailty in the community. Methods： In the community elderly health check-up population， 527 cases of the elderly over 60 years old were selected for investigation. The age was from 63 to 89 years old， and the average age was （71.70±5.75） years old; among them， there were 222 males with an average age of （71.71±5.59） years; there were 305 females with an average age of （71.69±5.87） years. Through field collection of medical history and Fried frailty phenotype scale and other information， and 4m pace and grip strength measurement， the prevalence and influencing factors of frailty in the elderly were analyzed. Results： The prevalence of frail elderly in the community was 8.0%， the prevalence of the male was lower than that of the female （3.2% vs 11.5%， P<0.01）， and the prevalence of female elderly frailty increased with age（P<0.01）. Compared with the non-debilitated elderly， the age of the pre-debilitated， and debilitated elderly（P<0.01）， and the number of chronic diseases increased（P<0.05）. The prevalence of frailty among illiterate or semiilliterate， elementary and junior high school seniors was 12.5%， 4.1%， and 1.7%（P<0.01）; the prevalence of the elderly living alone was higher than that of the elderly living together（15.2% vs. 6.7%， P<0.01）. Logistic regression analysis showed that women， advanced age， and the number of chronic diseases were risk factors for elderly debilitating in the community， while living with others and exercising were protective factors. Conclusion： The prevalence of frailty among the elderly in a community in the suburbs of Shanghai is 8.0%， and gender， age， living status， exercise frequency and the number of chronic diseases are the influencing factors of frailty in the elderly.

KEY WORDS frailty; prevalence; influence factor; Fried frailty phenotype

截至2018年底，我国65岁及以上老年人接近1.67亿，占总人口的11.9%[1];预计2050年老年人口将增长到4.83亿，老年人口占比将升至34.1%[2]。随着老年人口的增长，老年人健康日益引起关注，老年衰弱成为近年来老年医学研究的热点之一。老年衰弱是“由于年龄相关神经肌肉、代谢和免疫系统的生理储备下降，从而更易受应激因素影响的状态”[3]。衰弱与跌倒、失能、谵妄、死亡、残疾等负面事件密切相关[4-5]。老年衰弱及其不良后果影响患者的健康，给家庭和社会增加了负担。本研究旨在分析社區老年衰弱患病率及其影响因素，为社区老年衰弱的健康管理提供依据。

1 对象与方法

1.1 对象

于2019年6-9月对在上海市奉贤区四团社区卫生服务中心进行健康体检的60岁及以上老年人通过分级抽样，抽取527例老年人进行调查。年龄63～89岁，平均年龄为（71.70±5.75）岁;其中男性222人，平均年龄为（71.71±5.59）岁;女性305人，平均年龄为（71.69±5.87）岁。……