我国老年人健康期望寿命测算及其影响因素研究

背景　随着经济的快速发展和医疗水平的改善,老年人的预期寿命延长,然而寿命的延长并不意味着生命质量也得到提升。健康期望寿命作为评估人群健康生存状况的指标,既考虑了生命的长度同时也反映了生命的质量,可以更好地评价人群的健康状况。目的　探讨我国老年人的健康期望寿命现况及其影响因素,为改善老年人的健康状况提供参考。方法　2021年3—4月,基于中国老年健康影响因素跟踪调查（CLHLS）2014—2018年的随访数据,运用多状态生命表法计算≥70岁老年人的自理健康期望寿命和自评健康期望寿命,进而估算老年人的健康期望寿命,运用多元逐步线性回归分析方法对影响老年人健康期望寿命的因素进行分析。结果　共纳入≥70岁老年人5 261例,其自理健康期望寿命和自评健康期望寿命随年龄组的增加呈现递减趋势,均以70~72岁年龄组最高,分别为17.85年和16.62年。88~90岁年龄组之前的年龄组自理健康期望寿命高于自评健康期望寿命,88~90岁年龄组及其之后年龄组自理健康期望寿命均稍低于自评健康期望寿命。多元逐步线性回归分析结果显示,性别、年龄、婚姻状况、受教育年限和焦虑情况是健康期望寿命的影响因素（P<0.05）;其中,低龄、已婚和不焦虑是自理健康期望寿命和自评健康期望寿命的保护因素,而男性和受教育年限低是自理健康期望寿命和自评健康期望寿命的危险因素（P<0.05）。结论　关注老年人的健康状况刻不容缓,应该加强对高龄、独居、受教育年限较低的人群健康状况的重视,积极开展社区健康教育,重视高龄老人的心理健康需求,提高高龄人群的健康水平。

Estimated Healthy Life Expectancy and Associated Factors among Chinese Elderly People

Background　Owing to rapid economic development and advances in healthcare services,the life expectancy of the elderly has increased. But longer life expectancy does not mean higher quality of life. Healthy life expectancy is a healthy survival indicator that assesses both the length of life and quality of life,so it may be better for assessing the health status of the population. Objective　To estimate the healthy life expectancy of Chinese elderly people and associated factors,providing evidence for improving the health status of this population. Methods　This study was conducted between March and April 2021. Participants were part of the surveyees of the CLHLS during 2014—2018. The multistate life table was used to calculate healthy life expectancy and self-rated healthy life expectancy. Multiple linear regression was used to explore the factors associated with the healthy life expectancy. Results　A total of 5 261 subjects were included. Both the healthy life expectancy and self-rated healthy life expectancy showed a trend of decrease with age. The 70-72 age group had the longest average healthy life expectancy（17.85 years） and average self-rated healthy life expectancy（16.62 years）. The average healthy life expectancy was longer than the average self-rated healthy life expectancy in those younger than 88 years old. The average healthy life expectancy was slightly shorter than the average self-rated healthy life expectancy in 88-and-over age groups. Gender,age,marital status,education level and anxiety were main factors associated with healthy life expectancy（P<0.05）. Younger age,being married and non-anxiety might be associated with longer healthy life expectancy and self-rated health life expectancy,while being male and lower education level might be associated with shorter healthy life expectancy and self-rated health life expectancy（P<0.05）. Conclusion　To improve the health level of the elderly,especially those who are at an advanced age,live alone,have lower education level,it is suggested to pay attention to their health status,actively offer them community-based health education,and take interventions to satisfy their mental health needs as far as possible.