三河市开发区老年人健康状况的多维评价

目的：对老年人躯体健康、日常生活功能、精神健康、健康自评状况以及主要影响因素进行调查，以了解影响老年人健康的主要卫生问题。方法：采用整群抽样方法对三河市开发区717名60岁及以上老年人进行问卷调查。结果：老年人两周患病率为56．3％，慢性病患病率为92.1％，其中70．0％的老年人同时患有两种及以上慢性疾病，残疾率18％；日常生活活动能力(ADL)和工具性日常生活活动能力(IADL)受损率为1．8％和7．0％；生活满意度指数(LSIA)平均记分29分，21分及以上者占87．1％；健康自评不好的老年人占9.3％，63.1％的老年人认为健康问题对于日常想做事情没有影响；目前工作状况、慢性病指数、症状指数、高血压、LSIA是影响老年人健康自评的主要因素。结论：三河开发区老年人慢性病患病率高，日常生活功能受损率低，生活满意度高，健康自评状况较好。有必要针对不同情况采取不同的社区干预措施，以提高老年人整体健康水平。     

威海市农村老年人健康状况调查分析

目的通过调查了解威海市农村老年人的健康状况，为制定老年人保健措施提供依据。方法按照分层随机整群抽样的方法抽取威海市农民4550人，其中超过60岁的老年人1499人，利用自制调查问卷进行调查，用Access建立数据库。结果老年组1自感健康状况很好和好的为26．02％，显著低于非老年组（P〈0．00I），接受健康体检率为12．01％，2W患病率为17．75％显著高于非老年组（P〈0．00I），慢性病患病率为47．90％。结论老年人自感健康状况差，接受健康体检率低，慢性病患病率高，对卫生服务要求比较迫切，对老年人应多加关怀，使其平等和优先享受各种医疗卫生服务。     

上海市城乡老年人慢性病现况调查

目的：了解影响上海市城乡老年人健康和生存质量的几种常见慢性的现况。方法：按名单入户调查自报慢性病的患病情况。结果：老年人慢性病总患病率为60．3％,其中男性患病率59．4％,女性61．9％,女性高于男性。城区老年人慢性病总患病率为66．5％,明显高于农村（53．9％）,且城区女性高于男性,农村两性之间差异无显著性。城市老年人慢性病患病率由高到低前6位依次为高血压、白内障、慢性阻塞性肺疾病、冠心病、其他心脏病、糖尿病、其患病分别为33．6％、18．3％、11．9％、9．1％、7．9％、5．9％,农村老年人患病率由高到低依次为高血压慢性阻塞性肺疾病、白内障、耳聋、其他心脏病、骨畸形及骨质疏权症,其患病率依次为20．9％、15．2％、7．0％、5．7％、4．3％、4．2％。结论城乡之间慢性病分布现状和特点差异有显著性,针对不同情况应采取不同的预防措施,以提高老年人的健康水平和生存质量。     

山东省老年人卫生服务利用现状及影响因素

目的探讨山东省老年人卫生服务需要及其影响因素。方法利用第五次国家卫生服务调查山东省老年人的数据,分析山东省老年居民的卫生服务需要及利用现状,利用单因素分析和Logistic回归分析方法对山东省老年人卫生服务利用的影响因素进行分析。结果山东省老年居民的2 w患病率为49.2%,2 w就诊率为12.0%,慢性病患病率为58.8%,年住院率为14.9%。Logistic回归分析发现影响老年人2 w就诊(门诊服务利用)的因素有地区、老年人的年龄、文化程度、婚姻状况、就业状况以及是否患有慢性病,影响老年人年住院(住院服务利用)的因素有性别、就业状况、是否有医疗保险以及是否患有慢性病。结论山东省老年人卫生服务需要量大,但卫生服务利用度不足。应加强对老年人的健康教育,提高基层卫生服务机构的质量,促进老年人对卫生服务的利用。     

社区老年人卫生服务有赖于全科医疗

目的探讨社区老年人慢性病的防治和管理。方法对长风地区100位≥60岁老年人健康影响因素进行调查分析。结果老年人各种慢性病患病率为82%。平均每位老年人患病1.62种。老年人对社区卫生服务需求中较迫切的是就近医疗占65%,健康教育,上门服务各占42%与40%。结论要进一步在全科医疗实践中探索老年社区卫生服务模式。建立以老年人为中心,家庭为单位,社区为范围,社区服务中心为基础的全方位检测的基础服务系统。对老年人实施三级监护,提供三级卫生服务,开展老年人健康教育,健康促进,改变不良的生活方式,改善健康功能,提高生活质量,降低医疗保健费用。     

农村地区老年人卫生服务利用情况及满意度

目的了解农村地区老年人卫生服务利用情况及满意度。方法采用随机抽样的方法,对北京市郊区3个县203位老年人进行问卷调查。结果 (1)不同医疗费用支出的老年人2 w患病率存在显著差异。(2)不同性别和文化程度的老年人体检情况存在显著差异。(3)定期的慢性病筛查对老年人身体健康有积极影响。(4)文化程度、家庭经济状况、是否参加医疗保险是老年人卫生服务满意度的重要影响因素。结论(1)健全农村卫生服务体系,积极探索符合老年人特点的医疗服务模式。(2)利用多种形式加强针对老年人的健康教育。(3)慢性病管理是农村基本公共卫生服务的重点。(4)农村老年人卫生服务的满意度有待提高。     

新疆65岁及以上居民两周患病及影响因素分析

目的　了解老年人口的健康状况及卫生需求 ,更好地为老年人群提供卫生服务。方法　采取分阶段整群随机抽样、入户调查的方法。结果　 65岁及以上老年人的两周患病率为 2 2 6.2‰ ,城市老人两周患病率高于农村 ,女性高于男性 ,族别、婚姻状况、文化程度、职业、慢性病对两周患病率的影响 ,具有显著性差异。结论　应针对影响老年人健康的因素及老年人对卫生服务的需求 ,开展一些老年人需要且能接受的卫生服务项目     

上海市南汇区老年人健康状况及其影响因素

目的 了解上海市南汇区老年人的健康状况,探寻其影响因素,为有针对性开展老年卫生保健服务提供依据.方法 采用三阶段分层随机抽样方法及非条件有序多分类Logistic回归分析方法.结果 所调查南汇区老年人2 w患病率15.38%;慢性病患病率73.76%,其中高血压患病率最高(51.20%);生活部分或完全需要别人帮助者占6.39%;健康状况自评较差及很差者占11.91%;患有慢性病、生活自理能力差及卫生服务可得性是影响老年人自评健康的主要因素.结论 需加强社区卫生服务和老年健康管理,以改善老年人生活质量.     

老年人卫生服务需求与利用的现况调查及影响因素

目的了解长治市老年人口卫生服务需求和利用情况及影响因素。方法分层整群抽取1 128名老年人。主要调查一般情况、健康状况、卫生服务的需求与利用、医疗保障情况。结果长治市老年人自我健康评价较高,62.6%老年人患有慢性病,2 w患病率为23.2%,年住院率为22.9%,平均住院天数为14 d。有老伴、文化程度高、收入水平越高、慢性病种类越多、自我健康评价越差、平时锻炼少、保健知识少、体检周期长患病后住院的越多。结论慢性病已成为老年人主要的健康问题,应加强社区卫生服务建设,针对老年人开展多种形式的服务。     

河北省农村老年人慢性代谢性疾病流行现状

目的了解河北省农村老年人慢性代谢性疾病流行和防治现状。方法随机抽取河北省藁城市梅花镇1085名老年人，统计分析其常见6种慢性代谢性疾病患病率及防治状况。结果老年人慢性代谢性疾病总患病率按患病人数计为85．5％，按患病例数计为178．3％；患病率女性高于男性；中心型肥胖、高血压、糖尿病、冠心病、脑卒中、血脂异常患病率分别为54．5％、61．4％、9．8％、9．8％、6．7％和30．2％；同时具有至少3种上述疾病特征的代谢综合征患病率为23．4％；慢性病患病知晓率、治疗率、控制率分别为高血压：37．1％、23．9％和5．7％，糖尿病：32．1％、4．2％、8.5％。结论农村老年居民慢性代谢性疾病患病率高，患病知晓率、治疗率和控制率低，亟需加强农村老年人慢性病预防控制工作。     

福州市城区老年人健康状况及社区卫生服务需求调查

目的 了解我市城区老年人健康状况及卫生服务需求,为福州市社区老年人卫生服务的开展和完善提供科学依据.方法 采用分层随机抽样方法,选取福州市城区3285例60岁及以上老年人进行问卷调查.结果 城区老年人的平均生活质量中等偏上,但社区老人受教育程度偏低,老年人慢性病患病率较高,患1种及以上慢性病者2134例(65.0%),且年龄越大,同时患多种慢性病的老年人所占的比例越高(P＜0.01),慢性病患病率前5位依次为:高血压、糖尿病、冠心病、骨关节病、脑卒中;老年人抑郁症状发生率高达60.3%;该区老年人对社区卫生服务总需求率为75.2%,年龄越大,所需求项目越多(P＜0.05),老年人对卫生服务需求排在前5位的是定期体检、健康教育、定期家访、保健指导、饮食指导.结论 福州市城区老年人存在不同程度的健康问题和多种卫生服务需求,应整合资源,为老年人提供多形式、多途径的社区卫生保健服务,以提高老年人的生活质量.

Abstract：

Objective To find out the health status and community health care requirement of the elderly in urban Fuzhou and to provide suggestions on how to develop and consummate the community health care for elderly. Methods With the method of stratified random sampling, 3285 elderly people aged 60 years and over were surveyed by a questionnaire. Results The average quality of life of elderly people in urban Fuzhou was above the moderate level. But education level of the elderly was low. And the prevalence rate of chronic diseases was high. There were 2134 elderly people (65.0%) who had more than one chronic disease. The older the people, the higher proportion the coincidence of multiple diseases (P＜0.01). The first five chronic diseases in the elderly were hypertension, diabetes, coronary heart disease, arthropathy and stroke. The incidence rate of depression was high up to 60%. The requirement rate of community health care was 75.2%, and the older the people, the more items they needed(P＜0.05). The requirement of community health care at the first 5 rank position were regular physical examination, health education, regular home visiting, health direction and diet direction. Conclusions Elderly people have many health problems and requirements of community health care.We should provide more and more community health care, in order to improve the quality of life of elderly people.     

天津市蓟县农村老年人尿失禁与慢性疾病及女性分娩史的关系

目的 了解天津市蓟县农村老年人尿失禁的患病情况和老年人尿失禁与慢性疾病及女性分娩史的关系. 方法 采用整群抽样的方法抽取天津市蓟县所辖的两个乡(镇)卫生院60岁及以上老年人743名,按统一设计的调查问卷,以面对面询问的方式进行入户调查,通过单因素和多因素分析,探讨农村老年人尿失禁与慢性疾病及女性分娩史的关系. 结果 天津市蓟县农村老年人尿失禁患病率为33.4%(248例),女性患病率高于男性(43.2%与22.8%,χ~2=34.70,P<0.0001).多因素Logistic回归分析结果显示,患呼吸系统、前列腺、神经系统、运动系统疾病的老年男性患者尿失禁风险比未患者高,其中患前列腺疾病和神经系统疾病的老年男性患尿失禁风险最高(OR值分别为11.47、11.76).老年女性中,便秘的老年人比无便秘者患尿失禁风险高(OR=1.46),患呼吸系统和运动系统疾病及糖尿病的老年女性患尿失禁风险比未患者高,其中患呼吸系统疾病的老年女性患尿失禁风险最高(OR=4.84);围产期孕次、产次越多患尿失禁风险越高(OR=1.03、1.02);分娩过程中会阴裂伤、伤口感染患尿失禁风险高(OR=1.72、1.65). 结论 天津市蓟县农村老年人尿失禁患病率较高,老年人尿失禁的发生与多种慢性疾病有关,同时女性分娩史也影响老年人尿失禁的发生.     

Symptomatic depression in elderly medical outpatients. I. Prevalence, demography, and health service utilization

The authors assessed the prevalence and demography of depressive symptoms, their association with specific chronic diseases, and their influence on health service use in a large sample of elderly men seen in a primary care setting. Twenty-four percent of respondents reported clinically significant depressive symptoms; the prevalence of major depressive disorders was estimated at 10%, but only 1% reported receiving mental health treatment by a specialist. Self-reported marital separation or divorce and physical disability affecting employment were strongly associated with high depression scores, whereas the normative stresses of aging (widowhood, retirement, social isolation) were not. Only chronic lung disease was differentially associated with high depression scores, and this effect was weak. The authors discuss the implications of these findings for the design of comprehensive health services for the elderly with chronic disease.     

Prevalence of gastrointestinal symptoms in the elderly: a population-based study.

The prevalence of chronic gastrointestinal symptoms and the irritable bowel syndrome (IBS) in the elderly, and their impact on health, is largely unknown. The prevalence of symptoms compatible with IBS was estimated in a representative sample of elderly community residents, and the impact of these symptoms was determined on presentation for health care. An age- and sex-stratified random sample of noninstitutionalized Olmsted County, Minnesota, residents aged 65-93 years were mailed a valid questionnaire; 77% responded (n = 328). The age- and sex-adjusted prevalence (per 100 persons) of frequent abdominal pain was 24.3 [95% confidence interval (CI), 19.3-29.2]. Chronic constipation and chronic diarrhea had prevalences of 24.1 (95% CI, 19.1-29.0) and 14.2 (95% CI, 10.1-18.2), respectively. Fecal incontinence more than once a week was reported in 3.7 per 100 (95% CI, 1.6-5.9). The prevalence of symptoms compatible with IBS (greater than or equal to 3 Manning criteria with frequent abdominal pain) was 10.9 per 100 (95% CI, 7.2-14.6). Among the subjects sampled who had abdominal pain, chronic constipation, and/or chronic diarrhea (n = 152), only 23% had seen a physician for pain or disturbed defecation in the prior year, and this behavior was poorly explained by the symptoms. It is concluded that complaints consistent with functional gastrointestinal disorders are common in the elderly, but symptoms are a poor predictor of presentation for medical care.     

The health status of community based elderly in the United Arab Emirates

Little is known about the elderly in the United Arab Emirates (UAE), a country with both developing country features (high fertility rate, few elderly, strong traditional culture) and developed country characteristics (high-income economy, urbanized population, high growth rate of people aged 65+ years). In this cross sectional survey of 184 randomly chosen community based people aged 65+ years, the mean age was 71.8 +/- 6.3, 52% were female, 76% were married, 11% were literate, 89% lived in multi-generational households, 85% lived in households with servants and 15% had a personal servant. Health status was largely independent of age. Compared with the ambulatory aged USA population, the rate of functional independence in activities of daily living (ADL) (83%) was similar and chronic medical problems were less frequent, with the notable exception of diabetes (37% UAE, 10-12% USA). Almost all (95%) participants in this study rated their health as satisfactory or higher, compared with 82% of US ambulatory elderly. There appeared to be a significant under-diagnosis of psychological problems. In the presence of a high regard for traditional values, close family ties, universal practice of religion and high economic resources, the elderly in the UAE have a high level of health, which they maintain into their later years. There may be a need to substantially increase health care resources for aged care in the near future due to the high prevalence of diabetes, amount of hidden psychological morbidity and known demographic trends. Encouraging families to continue to provide home based long-term care may minimize the need for government intervention in this area.     

北京市太阳宫、香河园地区老年居民健康状况及卫生服务需求调查

目的了解北京市太阳宫、香河园地区老年人群的健康状况及卫生服务需求,为进一步工作提供信息。方法自行设计问卷对相关辖区内做免费体检的60岁以上老年人进行问卷调查。结果老年人对健康自我评价为一般和差的比例分别为76.5%和7.2%。老年人慢性病患病率达74.6%,其中患有两种及以上慢性病老年人达38.0%。老年人对健康体检的需求为72.4%,对健康指导、上门医疗及家庭病床的需求分别为45.5%,35.2%及21.2%,并且不同年龄、不同文化程度的老年人需求不同。结论慢性病已成为这两个地区的主要健康问题,今后应加强做好防控工作。应针对老年人群的不同需求,开展多种形式与层次的服务。     

Prevalence rate of urinary incontinence in community-dwelling elderly individuals: the Veneto study

BACKGROUND: Urinary incontinence (UI) is a common problem in elderly people, due mainly to functional impairments and concurrent medical diseases. Few studies, however, have assessed the prevalence of UI in noninstitutionalized individuals. The objectives of the present work were to estimate the prevalence of UI in a community-based population of elderly Italians and to determine the associated physical, social, and psychological factors. METHODS: A random sample of noninstitutionalized men (n = 867) and women (n = 1531), aged 65 years and older, from the Veneto region of northeastern Italy, were interviewed at home, using an extensive multidisciplinary questionnaire, to assess their quality of life and social, biological, and psychological correlates. RESULTS: The prevalence rate of UI was of 11.2% among men and of 21.6% among women. Among those reporting the condition, approximately 53% of women and 59% of men reported experiencing incontinence daily or weekly. Association of UI was found for participants older than 70 years in both men (odds ratio [OR] 2.49, 95% confidence interval [CI] 1.45-4.28) and women (OR 1.49, 95% CI 1.11-2.02). Three of the medical conditions investigated were associated with increases in the odds in women, namely chronic obstructive pulmonary disease (OR 1.53, 95% CI 1.11-2.12), Parkinsonism (OR 2.27, 95% CI 1.14-4.54), and hip fracture (OR 1.38,95% CI 1.02-1.88), whereas chronic diarrhea was the only condition associated with UI in men (OR 6.92, 95% CI 2.22-21.5). Participants with a physical disability were two times more likely to report incontinence, and the odds were increased by 50% in women who had sleep disturbances. CONCLUSIONS: Incontinence is highly prevalent in the Italian elderly population, and several common chronic conditions are significantly associated with it. Moreover, very few people with incontinence seek health care or are aware of potential treatments.