中国高龄老人健康预期寿命的研究

目的　探讨中国高龄老人健康预期寿命。方法　利用≥ 80岁高龄老人 2年纵向研究 (1 998～ 2 0 0 0年 )资料 ,运用多状态寿命表法计算其预期寿命及健康预期寿命。结果　总体上女性高龄老人的预期寿命高于男性 ,但健康预期寿命占预期寿命的比重低于男性。城镇高龄老人预期寿命高于农村高龄老人 ,但其健康预期寿命、健康预期寿命占预期寿命的比重却低于农村高龄老人。结论　我国高龄老人有相当长的时期需要照顾 ,健康预期寿命为评价高龄老人生命质量提供重要的信息。     

广东省居民健康、伤残、死亡三者间的量效关系研究

目的采用图谱法解析居民健康、伤残、死亡三者间的量效关系.方法以居民年龄别为横坐标,以年龄别期望寿命（LE）、健康期望寿命（DALE）、伤残调整寿命年（DALY）为纵坐标,分别绘制出健康、伤残、死亡三者关系的量效图谱.结果居民健康、伤残、死亡三者关系量效图谱中LE=A＋B,DALE=A＋f（B）,DALY=C＋g（B）.女性的心血管疾病负担明显高于男性,男性的损伤与中毒疾病负担则明显高于女性.男性在呼吸疾病、恶性肿瘤、脑血管疾病和糖尿病等4类疾病的疾病负担上也均较女性为重.结论f（B）、g（B）是一种量效关系函数,它根据居民伤残状态的严重性权重,将在这种伤残状态下生活的年数转化成相当于在完全健康状态下生活的年数与死亡状态下损失的年数,从而直观反映居民健康、伤残与死亡的量效关系.     

北京市社区最低生活保障老年人群血脂情况调查及分析

目的研究北京市社区最低生活保障老年人群血脂特点及流行病学特征。方法对2012年9月至2012年11月,来我院进行健康体检的≥60岁北京市社区最低生活保障老年人进行血脂调查,共计582人,检测其血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C）水平,并进行实验室诊断,诊断结果与北京市社区普通老年居民血脂异常发生情况进行比较。同时,按年龄分为3组：60—69岁组、70—79岁组和80—90岁组,进行男性、女性组内血脂异常发生情况比较。结果北京市社区最低生活保障老年人群TC、TG及LDL—C异常比例均高于北京市社区普通老年人群（P〈0．05）,而HDL—C异常比例低于北京市社区普通老年人群（P〈0．05）。低保老年人各年龄组男性LDL—C异常比例均低于女性（P〈0．05）;60—69岁组及80-90岁组,男性TC异常比例低于女性（P〈0．05）;60—69岁组及70～79岁组男性TG及HDL—C异常比例高于女性（P〈0．05）：80。90岁组男性TG异常比例低于女性（P〈0．05）;低保老年人群总体血脂异常比例明显高于北京市社区普通老年人群（P〈0．05）,其中男性70～79岁组、女性60～69岁组血脂异常发生比例最高。结论北京市社区最低生活保障老年人群血脂异常比例较高,是北京市血脂异常防治的重点人群,而通过提高其生活水平,改善膳食结构,开展相关疾病的宣传教育,定期体检,合理药物控制,可降低该人群血脂水平,防止其心脑血管疾病的发生和发展。     

农村老年人认知功能障碍及其影响因素

目的：了解农村老年人的认知功能障碍现状及其影响因素。方法采用分层整群抽样的方法,对山东省郓城县年龄≥60岁的农村老年人488名进行面对面的问卷调查。结果郓城县农村老年人的简易精神状态量表（MMSE）得分为（21．02±6．48）;195名（40．0％）存在认知障碍;日常生活自理能力（ADL）得分与MMSE得分负相关（r＝－0．730,P＜0．05）;ADL得分与 MMSE 各因子得分的轮廓分析,三组间轮廓不平行（F＝30．780,P＜0．05）,正常组的轮廓得分高于下降组,高于明显障碍组。女性、体力劳动、离婚或丧偶、收入低、患有慢性病、ADL差是老年人认知障碍的危险因素,受教育水平高是保护因素。结论农村老年人的认知功能较低、影响因素较多,可从病有所医、老有所养、老有所学等方面进行早期干预。     

高龄老年男性和女性骨健康状况差异分析

目的探讨高龄老年男性和女性骨健康状况差异。方法将2004年5月至2008年10月在复旦大学附属华东医院进行双能X线骨密度仪测定骨密度(bone mineral density,BMD)≥60岁及以上的老年男性1 227例和女性1 637例纳入本研究,按每10岁为1个年龄段分组,比较各组腰椎、髋部骨密度和骨生化指标及骨折发生率。结果 (1)BMD:年龄≥90岁男性组髋部各部位骨密度、男性80~89岁组、70~79岁组、60~69岁组腰椎与髋部均明显高于同年龄组女性骨密度,差异有统计学意义(P均0.05)。(2)骨折发生率:至少1次骨折的发生率60~69岁组、70~79岁组、80~89岁组女性均明显高于同年龄男性组,差异有统计学意义(P均0.05)。(3)骨生物化学标志物:60~69岁组、70~79岁组血清骨钙素(osteocalcin,BGP)、尿骨吸收标志物Ⅰ型胶原羧基端肽/肌酐(carboxy terminal peptide of typeⅠcollagen/crea,CTX/cr)、尿吡啶啉/肌酐(pyridinoline/crea,Pyd/Cr)、尿脱氧吡啶啉/肌酐(deoxypyridinoline/crea,D-Pyd/Cr)均明显高于同年龄男性组,差异有统计学意义(P均0.05)。80~89岁组女性尿Pyd/Cr、D-Pyd/Cr均明显高于同年龄段男性,差异有统计学意义(P0.05)。结论性别影响高龄老人骨密度和骨折发生率,性别对高龄老人骨代谢标志物有影响。     

江苏省老年高血压流行病学调查资料分析

本文对１９９１年１０月江苏省高血压流行病学抽样调查中６０岁以上老年人群资料进行了分析。结果显示：①城市老年人确诊高血压患病率为２９．０％，农村为１５．１％，城市非常显著高于农村（Ｐ＜０．０１）；②随着年龄的增加，老年人收缩压继续增加，而舒张压则略有下降；③老年人高血压的显著特点是以纯收缩期高血压为主，城市占６２．２％，农村占６４．４％，女性纯收缩期高血压的比例显著高于男性；④城市老年人在７０岁以前高血压患病率男性高于女性，７０岁以后女性高于男性，而农村老年人在各年龄组女性均非常显著高于男性。     

城乡高龄健康老人日常生活能力的比较

目的 评估城市和农村的高龄老年人日常生活活动能力的差异.方法 在北京市随机抽取城市和农村的高龄(80岁以上)老年人607人(包括农村组234人、城市组373人),使用日常生活活动能力量表(ADL)进行测评,对结果进行对比分析.结果 (1)农村老年人,在使用公共车辆、做饭、洗澡、打电话、独自在家和总的日常生活活动能力方面和城市老年人有明显的差距.(2)居住在农村的男性在打电话方面能力较城市组减弱;居住在农村的女性在自己搭公共汽车、做家务、洗澡、打电话方面能力较城市组减弱.结论农村的高龄老年人,尤其是女性,日常生活能力的减退较为突出.     

内蒙古准格尔旗35岁及以上人群卒中患病和血脂水平的现况调查

目的 探讨内蒙古准格尔旗≥35岁人群的卒中患病情况和血脂水平的关系.方法 采用整群随机抽样方法,抽取内蒙古准格尔旗常住居民,进行统一体格检查、问卷调查和实验室检查,收集资料并进行统计学分析. 结果 ①2007年4-12月本次流行病学研究共计调查72 350人,应答率为88.7％,其中非卒中69 762人,卒中2588例,卒中患病率为3.58％.②35～44岁、45～ 54岁、55～ 64岁、65～74岁和≥75岁年龄组卒中患病率分别为0.46％、1.46％、4.68％、7.35％和6.28％,随着年龄增长而上升（≥75岁组略为下降）,差异有统计学意义（P＜0.01）.③脑梗死（x2 =448.361,P＜0.01）、脑出血（x2=105.243,P＜0.01）患病率均随年龄增长而上升.45～54岁年龄组男性脑梗死患病率（1.27％）高于女性（0.96％）;55～ 64岁年龄组男性脑出血患病率（1.35％）高于女性（1.00％）,差异均有统计学意义（P＜0.01）.④女性血清胆固醇（TC）、三酰甘油（TG）的平均值高于男性,差异均有统计学意义（P＜0.05）.＞55岁年龄组女性TC、TG水平高于同年龄段男性,差异均有统计学意义（P＜0.05）.⑤脑梗死发生率均随TC、TG水平的升高而增加,与正常水平组比较,其相对危险性亦升高（均P ＜0.01）.TC≥5.68 mmol/L患者的脑出血发生率高于TC正常水平者,相对危险性亦提高（P＜0.01）. 结论 内蒙古准格尔旗≥35岁人群卒中患病率为3.58％,患病率随年龄增长而升高;男性在45 ～54岁、55 ～64岁年龄段的脑梗死、脑出血患病率高于同年龄段的女性;＞55岁年龄组女性的TC、TG水平高于同年龄段男性;脑梗死发生率均随TC、TG水平的升高而增加.     

北京地区城乡人群吸烟状况比较

了解北京地区城市和农村人群中吸烟率的水平、分布特征，比较城市及农村之间不同性别、年龄及文化程度人群吸烟特性的差异，为今后在人群中开展戒烟干预活动提供基础资料。采用问卷调查的形式，对中关村及北京大学地区的城市居民和四季青地区的农民进行分层随机抽样调查。被调查者年龄范围为２５岁至６４岁。调查项目包括：一般情况、吸烟状况、测量血压水平、血脂水平等。（１）农村人群的吸烟率高于城市人群（男性：农村７５％，城市４９％；女性：农村１６％，城市４．６％）。（２）无论男性或女性，相同文化程度及年龄组的人群中农村人群的吸烟率均高于城市人群。（３）从总体上看，男性吸烟率高于女性，文化程度较低的人群吸烟率高于文化程度较高的人群，男性和女性人群的吸烟率随年龄段增加而变化的趋势不同。（４）无论城市或农村男性吸烟者的吸烟量高于女性吸烟者。城乡之间不同年龄段及不同文化程度吸烟者的烟量无明显差异。男性烟民中吸烟量有随文化程度的增加而减少的趋势，但未达到统计学显著性差异     

体检人群血浆致动脉硬化指数与血清ApoB／ApoA1比值的相关性研究

目的：探讨杭州地区体检人群的血浆致动脉硬化指数（AIP ）与ApoB/ApoA1比值的相关性。方法选取8990例体检人员,按性别和年龄进行分组,检测并分析不同性别、年龄组间的AIP、ApoB/ApoA1、LDL-C/HDL-C比值及其各指标间的相关性。结果 AIP、ApoB/ApoA1、LDL-C/HDL-C水平男性组均明显高于女性组,差异有统计学意义（ P＜0.01）。各年龄组AIP、ApoB/ApoA1、LDL-C/HDL-C水平差异有统计学意义（ P＜0.01）,且女性组随年龄增高上述各指标水平有增高趋势。ApoB/ApoA1比值≥0.9组无论男性或女性组,AIP、LDL-C/HDL-C水平均明显高于ApoB/ApoA1＜0.9组,差异有统计学意义（ P＜0.01）。Pearson相关分析显示,AIP与ApoB/ApoA1、LDL-C/HDL-C有较好的相关性（ r＝0.54、0.60,P＜0.01）。结论 AIP结合ApoB/ApoA1比值对预示动脉粥样硬化风险判断可能更有价值。     

2013年四川省广安市广安区居民主要死因分析

目的 了解四川省广安市广安区居民死亡水平和死亡原因,为政府制定有效防控对策提供科学参考依据。方法 对广安区2013年居民死亡资料,按照《国际疾病分类》（ICD-10）进行死因归类,用死亡率、构成比、死因顺位和期望寿命进行分析。结果 2013年广安区户籍人口粗死亡率654.36/10万,标化后死亡率579.42/10万,慢性病死因构成比为84.09%,成为广安区居民主要死因。2013年人均期望寿命经标化后为76.72岁,其中男性74.03岁,女性79.87岁。结论 慢性非传染性疾病已经成为广安区居民生命威胁的首因,恶性肿瘤则是慢病中的头号杀手。     

Trends in health expectancy indicators in the older adult population in Belgium between 1997 and 2004

The objective is to assess if longer life in Belgium is associated with more healthy years through the evaluation of trends (1997–2004) in health expectancy indicators at ages 65 and 80 covering different health domains: self-perceived health, chronic morbidity, disease clusters, and disability. Information was obtained from Belgian Health Interview Surveys. Health expectancies were calculated using the Sullivan method. Among males at age 65, the increase in years expected to live without chronic morbidity, without a disease cluster or without disability exceeded the increase of the life expectancy (LE). The rise in LE in good self-perceived health was equal to the gain in LE. Among women at age 65 and among men and women at age 80, none of the changes in the expected years of life in good health in any health domain were statistically significant. At age 65 among women, the increase in LE was smaller than the increase in years without chronic disease or without disability. The increase in years without disease clusters was less that the LE increase. At age 80 among men, the years without disability increased as the LE, with a shift toward years with moderate limitations. In any other health domains for men (except co-morbidity) and in all domains for women the years in good health either decreased or increased less than the LE. The recent rise in life expectancy in Belgium is, among the youngest old and especially among males, accompanied by an improved health status. At age 80 and particularly among women expansion of unhealthy years prevails.

肺结核病对寿命影响分析

目的　研究肺结核病对寿命的影响。方法 利用居民死亡原因回顾调查数据库资料,采用简略寿命表计算去肺结核病期望寿命,在1～70岁年龄范围内计算PYLL、PYLL率、PYLL标化率。结果 (1)男性肺结核死亡率为0.17‰,女性为0.07‰,性别比为2.43∶1;(2)肺结核死亡率最高峰年龄组为70～74岁,死亡人数高峰年龄段为55～79岁;(3)去肺结核病后期望寿命增加0.25岁,男性增加0.32岁,女性增加0.16岁;(4)全死因的PYLL等于1282858,肺结核病的PYLL等于28425,占全死因的2.22%;(5)PYLL_(1～70)率为1.28‰,其中男性为1.59‰,女性为0.95‰;(6)标化PYLL_(1～70)率为1.14‰,其中男性为1.41‰,女性为0.85‰。结论 肺结核病对期望寿命和居民寿命损失的影响已很小,不是引起人群“早死”的最重要原因,但仍是危害人群寿命的重要疾病之一,应继续做好结核病控制工作。     

Gender gaps in life expectancy and expected years with activity limitations at age 50 in the European Union: associations with macro-level structural indicators

Women generally live longer than men, but women’s longer lives are not necessarily healthy lives. The aim of this article is to describe the pattern of gender differences in expected years with and without activity limitations across 25 EU countries and to explore the association between gender differences and macro-level factors. We applied to the Eurostat life table’s data from the Statistics of Income and Living Conditions Survey to estimate gender differences in life expectancy with and without activity limitations at age 50 for 2005. We studied the relationship between the gender differences and structural indicators using meta-regression techniques. Differences in years with activity limitations between genders were associated with the life expectancy (LE) and the size of the gender difference in LE. Gender difference in years with activity limitations were larger as the gross domestic product, the expenditure on elderly care and the indicator of life-long learning decreased, and as the inequality in income distribution increased. There was evidence of disparity in the associations between the more established EU countries (EU15) and the newer EU10 countries. Among the EU15, gender differences were positively associated with income inequality, the proportion of the population with a low education and the men’s mean exit age from labour force. Among the EU10, inequalities were smaller with increasing expenditure in elderly care, with decreasing poverty risk and with decreasing employment rate of older people. The association between structural indicators and the gender gap in years with activity limitations suggests that gender differences can be reduced.     

Active life expectancy: factors influencing regional and gender differences]

Active life expectancy (ALE) is defined as an expected duration to be spent with a certain level of physical/mental function. The objectives of this article are to indicate ALE values based on our prospective observation, and to discuss factors influencing regional and gender differences in ALE values. We estimated ALE without disability in basic activities of daily living (ADL) on a 5% random sample (n = 3,459) of the residents aged 65 years and over in Sendai City between 1988 and 1991. At the age 65, ALE was 14.7 years for men and 17.7 years for women. ALE occupied 91% of the total life expectancy for men and 87% for women. As compared with the reports for the American elderly, ALE was longer in Sendai than in the United States. The duration to be spent with disability was shorter among the subjects in Sendai. We estimated ALEs in three functional areas: basic ADL, instrumental ADL, and mobility, on all the residents aged 65 years and over (n = 3,590) at Wakuya Town between 1994 and 1996. For both sexes, ALE in IADL was shorter than those in basic ADL and mobility. The development and progression of disability were different between sexes: men experienced disability at a younger age and progressed at a faster rate than women.     

Poverty and mortality among the elderly: measurement of performance in 33 countries 1960–92

This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960–92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.     

Life expectancy with and without cognitive impairment among Brazilian older adults

Estimating the life expectancy with and without cognitive impairment in an older adult population is critical for understanding the burden of illness on individuals and their families, the health care system, and society at large. This paper presents and compares estimates of life expectancy with and without cognitive impairment for the noninstitutionalized population ages 60 years and older in São Paulo, Brazil, for the years 2000 and 2010. Life expectancy with and without cognitive impairment was calculated using the Sullivan method and prevalence estimates from data collection at two points (2000 and 2010) of the Health, Well-Being, and Aging (SABE) Study. Results indicate that 60-year-old men in São Paulo in 2000 could expect to live 14.8 years and women 17.9 years without cognitive impairment. By 2010, life expectancy without cognitive impairment had increased to 17.1 years for men and 20.0 years for women. Length of life with cognitive impairment differed by gender (2.3 years for men and 3.7 years for women at age 60 in 2010). However, the absolute number of years with cognitive impairment remained relatively constant with age. The results indicate a trend for improvements in life expectancy without cognitive impairment over time in São Paulo. Adults in Brazil still face many years of cognitive impairment in their older years, particularly when compared with estimates from developed countries.     

Death rates at specific life stages mold the sex gap in life expectancy

Why do women live longer than men? Here, we mine rich lodes of demographic data to reveal that lower female mortality at particular ages is decisive—and that the important ages changed around 1950. Earlier, excess mortality among baby boys was crucial; afterward, the gap largely resulted from elevated mortality among men 60+. Young males bear modest responsibility for the sex gap in life expectancy: Depending on the country and time, their mortality accounts for less than a quarter and often less than a 10th of the gap. Understanding the impact on life expectancy of differences between male and female risks of death by age, over time, and across populations yields insights for research on how the lives of men and women differ.

Between ages 15 and 40, death rates for men are usually two or three times higher than death rates for women. This disparity has fueled widespread interest in the ratio of male to female death rates over the life course and in why it is exceptionally high for younger adults (1–6). Between ages 15 and 40, however, numbers of deaths are relatively low, so the high ratio of male to female death rates has a modest impact on the gap between female and male life expectancies. The sex difference in life expectancy hinges on differences in mortality risks at the ages when deaths are relatively common (7). Up through the early decades of the 20th century, these ages were at both extremes of life, infancy and old age. Afterward, death mostly struck after age 60. Here, we investigate variation across populations, over time, and over the life course in absolute and relative differences in mortality for men and women. We discuss what insights can be gained by scrutinizing relative risks compared to what can be learned by analyzing absolute risks.     

Trends in healthy life expectancy in Hong Kong SAR 1996–2008

Although Hong Kong has one of the best life expectancy (LE) records in the world, second only to Japan for women, we know very little about the changes in the health status of the older adult population. Our article aims to provide a better understanding of trends in both chronic morbidity and disability for older men and women. The authors compute chronic morbidity-free and disability-free life expectancy and the proportion of both in relation to total LE using the Sullivan method to examine whether Hong Kong older adults are experiencing a compression of morbidity and disability and whether there is any gender difference in relation to mortality and morbidity. The results of this study show that Hong Kong women tend to outlive Hong Kong men but are also more likely to suffer from a ‘double disadvantage’, namely more years of life with more chronic morbidity and disability. There has also been a significant expansion of chronic morbidity, as chronic morbidity-free life expectancy (CMFLE) decreased substantially for both genders from 1996 to 2008. Although disability-free life expectancy (DFLE) increased during this period, it increased at a slower pace compared to LE. The proportion of life without chronic morbidity also declined remarkably during these 12 years. Among the advanced ages, the proportion of remaining life in good health without disability has decreased since 1996, indicating a relative expansion of disability.