[Study on activities of daily living disability in community-dwelling older adults in China].

Objective: To investigate the disability status and its epidemiological characteristics in the elderly in urban and rural communities in China. Methods: The participants were from the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China conducted in 2015. A total of 23 803 urban and rural residents aged over 60 years were selected through stratified multi-stage cluster sampling in 6 provinces for a set of standardized questionnaire interview and physical examinations. Activities of daily living (ADL) scale was used to assess the disability status of the elderly. χ(2) test was used to analyze the difference in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) disabilities in different elderly populations. Multivariate logistic regression model was used to analyze the influence factors for disability. Results: Taking bath had the highest impairment rate (1.7%) while eating had the lowest impairment rate (0.6%) in BADL. Making phone call had the highest impairment rate (16.6%), followed by taking bus (5.5%) and taking medicine (1.8%) in IADL. The BADL and IADL disability rates in community seniors were 2.1% and 19.1%, respectively. BADL disability rate was higher in females, the widowed, illiterate, the elderly with low body weight or obesity (P<0.05). IADL disability rate was higher in females, rural residents, the widowed, the elderly with lower educational level or lower body weight (P<0.05). Multivariate analysis showed that risk for BADL disability increased with age and abnormal BMI, and decreased with the increase of education level. The risk factors for IADL disability included being female, age, rural residence, being widowed and low BMI. The risk for IADL disability was lower in those with higher education level and overweight or obesity. Conclusion: The present study showed that the disability rate was high in the elderly in China, which was influenced by the aging and multi demographic characteristics of the elderly. It is important to strengthen the prevention of BADL and IADL disabilities and intervention in the elderly.目的： 调查我国城乡社区老年人失能现状及其流行特征。 方法： 调查对象来自2015年老年期重点疾病预防和干预项目。采用多阶段分层整群随机抽样，抽取6省市共23 803名≥60岁城乡社区老年人，对其进行问卷调查和身体测量，采用日常生活活动能力量表（ADL）评估老年人失能情况。采用χ(2)检验分析基础性日常生活活动能力量表（BADL）和工具性日常生活活动能力量表（IADL）各项功能受损率及BADL/IADL失能率在不同特征老年人群间的差异，采用多因素logistic回归模型分析失能的影响因素。 结果： BADL功能中洗澡受损率最高（1.7%），吃饭受损率最低（0.6%）；IADL功能中打电话受损率最高（16.6%），其次是乘公共汽车（5.5%），吃药受损率最低（1.8%）。社区老年人BADL失能率2.1%，IADL失能率19.1%。BADL失能率在女性、无配偶、文盲、低体重和肥胖老年人中较高（P<0.05）。IADL失能率在女性、农村、无配偶、低文化程度和低体重老年人中较高（P<0.05）。多因素分析显示，BADL失能的危险性随年龄增加而升高，非正常体重也增加其危险性，而文化程度较高的老年人群BADL失能的危险性相对较低。增加IADL失能的危险因素有女性、增龄、农村、无配偶和低体重；而文化程度高和肥胖的老年人群IADL失能的危险性相对比较低。 结论： 本研究结果显示，受年龄老化和人口学诸多因素影响，我国老年人群失能率仍维持在一个高水平，加强老年人群躯体性的和工具性的日常生活活动能力下降预防和干预工作是非常必要的。.