老年人日常生活能力与某些疾病关系的社区调查

目的调查上海市老人日常生活能力（ＡＤＬ）状况及各类疾病发生率，分析痴呆综合征与其他疾病对老人ＡＤＬ的影响。方法采用我国修订版ＡＤＬ量表与疾病检询清单，经筛查和确诊，以３７４５名≥６５岁社区老人为分析样本，对６５～７４岁及≥７５岁两组分别予Ｌｏｇｉｓｔｉｃ多元回归分析，观察年龄、性别、文化程度及各类疾病变量对ＡＤＬ依赖的作用。结果ＡＤＬ依赖发生率达８．２８％，随年龄每增递１０岁，依赖发生成倍增长。疾病发生率（＞２０％）居前者的有高血压、心脏病、眼及关节疾病，痴呆为４．６１％。对两组老人影响最甚的疾病为脑卒中、震颤麻痹、痴呆、糖尿病及肺气肿。≥７５岁高龄组还析出癌症、动脉硬化、高血压等风险因子，痴呆的影响仍很显著。结论以Ａｌｚｈｅｉｍｅｒ′ｓ病为主的痴呆综合征是影响老人ＡＤＬ的严重疾病之一，亟待引起全社会的关注，应加强社区康复及医疗保健措施，以改进社区老人的生活质量。

Community investigation of the activities of daily living (ADL) and medical conditions of the elderly in Shanghai

OBJECTIVE: To study the ADL status and prevalence of medical conditions in aged population in Shanghai, and to analyze the impact of dementia syndrome and other illnesses to ADL performance. METHODS: Both the Chinese version of ADL scale (five items) and the list of self-reported illnesses questionnaire (32 conditions) were used in the survey. After screening and case-identification, 3745 noninstitutionalized aged residents, who were 65 years and older, were included in the analysis sample. A separate multiple logistic regression model was used in both groups (65-74 years and over-75), observing the effect of age, gender, education and medical conditions (as control variables) on ADL dependence. RESULTS: The prevalence rate of functional dependence in ADL was 8.28%, and the prevalence curve was doubled steeply along with each ten years. The most prevalent medical conditions (> 20%) were hypertention, heart disease, cataract/glaucoma and artheritis/rheumatism, whereas, dementing disorder was 4.61%. Of all illnesses, stroke, Parkinson's disease, dementia, diabetes and emphysema were the most important predictors of ADL dependence in both aged groups. In the group more than 75 years old, cancer, arteriosclerosis and hypertension seemed to be strongly related to ADL dependence, dementia syndrome was one of the remarkable risk factors. CONCLUSION: Dementing disorders such as Alzheimer's disease may lead to severe disturbance of ADL performance in the aged, therefore, the community rehabilitative measures and health care services should be stressed by the society to improve the quality of life of the elderly.