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Abstract：
OBJECTIVE: To identify the factors associated with the care needs of the older adults aged 65-105 by age groups, and to compare these factors across different age groups.
METHODS: A total of 12 244 older adults from the Chinese longitudinal healthy longevity survey (CLHLS) conducted in 2018 were included in the analyses. The participants were categorized into three age groups: young-old (aged 65-79), middle-old (aged 80-89), and oldest-old (aged 90-105). The level of disability was measured by the disability index (DI) in four dimensions, reflecting their care needs. Potential factors associated with care needs were selected based on the health ecological model (HEM), including perspectives of personal characteristics, behavioral characteristics, interpersonal network, living and working conditions, and policy environment. Multifactor analysis was performed using multinomial Logistic regression.
RESULTS: Among China \' s 12 244 older adults, 43.4% had medium or high care needs. Factors for higher care needs of older adults included higher age, higher number of chronic diseases, no exercise habit, excessive sleep duration (≥9 h/d), depressive tendency, living with children or spouse, and uneducated (all P < 0.05). In addition, the young-old group who were past smokers (OR=2.009, 95% CI: 1.019-3.959), were past drinkers (OR=2.213, 95% CI: 1.141-4.291), and reported self-perceived poverty (OR=2.051, 95% CI: 1.189-3.540), had higher level of care needs. The middle-old group who were female (OR=1.373, 95% CI: 1.038-1.817), never drank alcohol (OR=1.551, 95% CI: 1.059-2.269), and were lack of medical insurance (OR=1.598, 95% CI: 1.053-2.426), and had higher level of care needs. The oldest-old group who were female (medium care needs vs. low care needs: OR=1.412, 95% CI: 1.062-1.878; high care needs vs. low care needs: OR=1.506, 95% CI: 1.137-1.993), reported self-perceived poverty (OR=2.064, 95% CI: 1.282-3.323), and were lack of medical insurance (OR=1.621, 95% CI: 1.148-2.291), and had higher level of care needs.
CONCLUSIONS: The identical factors associated with care needs across different age groups include age, chronic disease, exercise, sleep, depression, living arrangement, and education. Smoking, alcohol consumption, and economic status are specific factors among the young-old group of the older adults, while gender and medical insurance are specific factors among the middle-old and the oldest-old group of the older adults. We recommend conducting prospective cohort studies and intervention studies among specific age groups on the above factors to provide reliable evidence for policy formulation.
METHODS: A total of 12 244 older adults from the Chinese longitudinal healthy longevity survey (CLHLS) conducted in 2018 were included in the analyses. The participants were categorized into three age groups: young-old (aged 65-79), middle-old (aged 80-89), and oldest-old (aged 90-105). The level of disability was measured by the disability index (DI) in four dimensions, reflecting their care needs. Potential factors associated with care needs were selected based on the health ecological model (HEM), including perspectives of personal characteristics, behavioral characteristics, interpersonal network, living and working conditions, and policy environment. Multifactor analysis was performed using multinomial Logistic regression.
RESULTS: Among China \' s 12 244 older adults, 43.4% had medium or high care needs. Factors for higher care needs of older adults included higher age, higher number of chronic diseases, no exercise habit, excessive sleep duration (≥9 h/d), depressive tendency, living with children or spouse, and uneducated (all P < 0.05). In addition, the young-old group who were past smokers (OR=2.009, 95% CI: 1.019-3.959), were past drinkers (OR=2.213, 95% CI: 1.141-4.291), and reported self-perceived poverty (OR=2.051, 95% CI: 1.189-3.540), had higher level of care needs. The middle-old group who were female (OR=1.373, 95% CI: 1.038-1.817), never drank alcohol (OR=1.551, 95% CI: 1.059-2.269), and were lack of medical insurance (OR=1.598, 95% CI: 1.053-2.426), and had higher level of care needs. The oldest-old group who were female (medium care needs vs. low care needs: OR=1.412, 95% CI: 1.062-1.878; high care needs vs. low care needs: OR=1.506, 95% CI: 1.137-1.993), reported self-perceived poverty (OR=2.064, 95% CI: 1.282-3.323), and were lack of medical insurance (OR=1.621, 95% CI: 1.148-2.291), and had higher level of care needs.
CONCLUSIONS: The identical factors associated with care needs across different age groups include age, chronic disease, exercise, sleep, depression, living arrangement, and education. Smoking, alcohol consumption, and economic status are specific factors among the young-old group of the older adults, while gender and medical insurance are specific factors among the middle-old and the oldest-old group of the older adults. We recommend conducting prospective cohort studies and intervention studies among specific age groups on the above factors to provide reliable evidence for policy formulation.
摘要：
目的：确定与65-105岁老年人护理需求相关的因素，并比较不同年龄段的这些因素。
方法：2018年进行的中国纵向健康长寿调查（CLHLS）共12244名老年人纳入分析。参与者分为三个年龄组：年轻人（65-79岁），中老年人（80-89岁），年龄最大（90-105岁）。残疾水平由残疾指数(DI)在四个维度上衡量，反映他们的照顾需要。根据健康生态模型(HEM)选择与护理需求相关的潜在因素，包括个人特征的观点，行为特征，人际网络，生活和工作条件，和政策环境。采用多项Logistic回归进行多因素分析。
结果：在中国12244名老年人中，43.4%有中等或高护理需求。老年人护理需求较高的因素包括年龄较高，更多的慢性疾病，没有锻炼习惯,睡眠时间过长（≥9h/d），抑郁倾向，与子女或配偶生活在一起,未受过教育(均P<0.05)。此外,过去吸烟的年轻老年组(OR=2.009，95%CI：1.019-3.959)，过去的饮酒者(OR=2.213，95%CI：1.141-4.291)，并报告了自我感知的贫困(OR=2.051，95%CI：1.189-3.540)，有更高的护理需求。中老年组女性(OR=1.373,95%CI:1.038-1.817),从不饮酒（OR=1.551，95%CI：1.059-2.269），并且缺乏医疗保险(OR=1.598，95%CI：1.053-2.426)，并且有更高的护理需求。年龄最大的女性群体(中等护理需求与低护理需求：OR=1.412，95%CI：1.062-1.878；高护理需求与低护理需求：OR=1.506，95%CI：1.137-1.993），报告的自我感知贫困(OR=2.064，95%CI：1.282-3.323)，并且缺乏医疗保险(OR=1.621，95%CI：1.148-2.291)，并且有更高的护理需求。
结论：与不同年龄段的护理需求相关的相同因素包括年龄，慢性疾病,锻炼,睡眠,抑郁症,生活安排,和教育。吸烟,酒精消费,和经济状况是老年人群的具体因素，而性别和医疗保险是中老年人和老年人群的特定因素。我们建议针对上述因素在特定年龄段进行前瞻性队列研究和干预研究，为政策制定提供可靠的证据。
方法：2018年进行的中国纵向健康长寿调查（CLHLS）共12244名老年人纳入分析。参与者分为三个年龄组：年轻人（65-79岁），中老年人（80-89岁），年龄最大（90-105岁）。残疾水平由残疾指数(DI)在四个维度上衡量，反映他们的照顾需要。根据健康生态模型(HEM)选择与护理需求相关的潜在因素，包括个人特征的观点，行为特征，人际网络，生活和工作条件，和政策环境。采用多项Logistic回归进行多因素分析。
结果：在中国12244名老年人中，43.4%有中等或高护理需求。老年人护理需求较高的因素包括年龄较高，更多的慢性疾病，没有锻炼习惯,睡眠时间过长（≥9h/d），抑郁倾向，与子女或配偶生活在一起,未受过教育(均P<0.05)。此外,过去吸烟的年轻老年组(OR=2.009，95%CI：1.019-3.959)，过去的饮酒者(OR=2.213，95%CI：1.141-4.291)，并报告了自我感知的贫困(OR=2.051，95%CI：1.189-3.540)，有更高的护理需求。中老年组女性(OR=1.373,95%CI:1.038-1.817),从不饮酒（OR=1.551，95%CI：1.059-2.269），并且缺乏医疗保险(OR=1.598，95%CI：1.053-2.426)，并且有更高的护理需求。年龄最大的女性群体(中等护理需求与低护理需求：OR=1.412，95%CI：1.062-1.878；高护理需求与低护理需求：OR=1.506，95%CI：1.137-1.993），报告的自我感知贫困(OR=2.064，95%CI：1.282-3.323)，并且缺乏医疗保险(OR=1.621，95%CI：1.148-2.291)，并且有更高的护理需求。
结论：与不同年龄段的护理需求相关的相同因素包括年龄，慢性疾病,锻炼,睡眠,抑郁症,生活安排,和教育。吸烟,酒精消费,和经济状况是老年人群的具体因素，而性别和医疗保险是中老年人和老年人群的特定因素。我们建议针对上述因素在特定年龄段进行前瞻性队列研究和干预研究，为政策制定提供可靠的证据。
