慢性病对我国老年人健康预期寿命影响的多状态研究-现代医学

慢性病对我国老年人健康预期寿命影响的多状态研究

单位：1. 广州中医药大学公共卫生与管理学院, 广东广州 510006;
2. 广西中医药大学公共卫生与管理学院, 广西南宁 530200

分类号：R1

出版年·卷·期（页码）：2025·53·第七期（1129-1134）

摘要：

目的：探索慢性病对我国60岁及以上老年人健康预期寿命(HLE)的影响情况，优化慢性病管理和老年人健康管理策略。方法：基于中国老年健康影响因素跟踪调查(CLHLS)2014—2018年追踪数据，分析我国60岁及以上老年人慢性病患病情况。首先，基于日常生活能力(ADLs)维度，利用多状态寿命表法将老年人的健康状态细分为3类：健康、不健康、死亡。其次，构建状态转换矩阵，模拟老年人在不同健康状态下的转换概率；进而用IMaCH软件来计算不同慢性病组各个年龄段老年人的HLE和预期寿命(life expectancy，LE)。最后，按照性别和居住地对老年人进行分组，分别测算他们在不同慢性病患病情况下的HLE，以从多个维度深入分析慢性病对我国老年人HLE的影响。结果：我国有超过八成老年人患有慢性病。慢性病组老年人HLE、 LE、HLE占比低于无慢性病组的老年人(60岁：19.38 vs. 21.62、21.51 vs. 23.79、90.11% vs. 90.89%)。相较于女性、城镇老年人，慢性病对中低龄组男性老年人、高龄组城镇老年人HLE的影响较大。结论：慢性病不仅影响寿命长度，更降低了生存寿命的质量。应重点关注中低龄组男性老年人、高龄组城镇老年人健康状况；加强对女性老年人HLE优势探究，针对中低龄老年人群应重点加强慢性病防治，针对高龄组人群的健康管理，应侧重于改善其生活环境和生活方式。

Objective:To explore the influence of chronic diseases on the healthy life expectancy(HLE) of the elderly aged 60 and above in China, and to help optimize the strategies of chronic disease management and health management of the elderly.Methods:Based on the follow-up data from 2014 to 2018 of Chinese Longitudinal Healthy Longevity Survey(CLHLS) in China, the prevalence of chronic diseases among the elderly aged 60 and over in China was analyzed. Firstly, based on the activities of daily living(ADLs), the health status of the elderly is divided into three categories by using the multistate life table method: healthy, unhealthy and dead. Secondly, a state transition matrix is constructed to simulate the transition probability of the elderly in different health States; Furthermore, IMaCH software is used to calculate the HLE and life expectancy(LE) of the elderly in different chronic disease groups. Finally, the elderly are grouped according to gender and living conditions, and their HLE under different chronic diseases is calculated respectively, so as to deeply analyze the influence of chronic diseases on HLE of the elderly in China from multiple dimensions. Results:More than 80% of the elderly in China suffer from chronic diseases. The proportion of HLE, LE and HLE in the elderly with chronic diseases was lower than that in the elderly without chronic diseases(60 years old: 19.38 vs. 21.62, 21.51 vs. 23.79, 90.11% vs. 90.89%). Compared with women and urban elderly, chronic diseases had a greater impact on HLE of young male elderlies and young rural elderlies. Conclusion: Chronic diseases not only affect the length of life, but also reduce the quality of life. We should focus on the health status of rural elderlies and strengthen the exploration of HLE advantages of female elderlies. The prevention and treatment of chronic diseases should be strengthened for middle-aged and young people, and for the health management for elderly people, the focus should be on improving their living environment and lifestyle.

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