1289例听力残疾人群分布特征及病因分析

目的了解甘肃省听力残疾人群分布特征及致残原因。方法采用分层、多阶段、整群概率比例抽样方法,对甘肃省63 249人进行调查,使用统一配发的便携式听力计对听力进行诊断。采用SPSS 13.0软件对数据进行统计分析。结果甘肃省第二次残疾人抽样调查中,听力残疾(含多重)患病率为2.04%,农村中患病率(2.19%)高于城市(1.29%)(P=0.000);男性(2.23%)高于女性(1.83%)(P=0.000)。听力残疾的患病率呈现随着年龄增加而增加的趋势(χ2=2 102.933,P=0.000),50岁以上年龄组患病率(5.58%)明显高于0~49岁年龄组(P=0.000)。听力残疾以三级、四级居多,分别占39.49%、34.91%。在主要致残原因中,老年性耳聋所占比例最大(40.50%),其次是中耳炎(18.63%),原因不明也是主要的致残原因。全身性疾病、创伤或意外伤害导致城市人群听力残疾患病率明显高于农村(χ2=9.480,P=0.002;χ2=5.776,P=0.016),中耳炎导致的农村人群听力残疾患病率明显高于城市(χ2=8.331,P=0.004)。结论 2006年甘肃省残疾人抽样调查中,听力残疾人群患病率低于全国和一些发达城市同类调查的水平。全身性疾病、创伤或意外伤害是城市人群听力残疾的主要致残原因,中耳炎是农村人群听力残疾的主要致残原因。听力残疾的防治重点应放在农村地区和男性人群中。     

中国少数民族残疾人的现况调查

目的 了解中国少数民族人口残疾现患率的流行特征.方法 以全国为总体,自治区、直辖市为次总体,利用多阶段分层整群概率比例抽样方法抽取2 526 145人,其中少数民族297 761人,由专业医生进行残疾相关问题询问、诊断和残疾等级评定.结果 中国少数民族和汉族人口残疾现患率分别为6.24%(95%CI:6.16%～6.51%)和6.41%(95%CI:6.38%～6.51%).少数民族和汉族人口标化残疾现患率为7.04%和5.98%,少数民族高于汉族.少数民族人口标化残疾率男性高于女性(7.31%vs.6.75%).少数民族人口肢体残疾现患率水平最高,为1.90%(95%CI:1.89%～1.91%),其次是听力残疾1.34%(95%CI:1.33%～1.35%)、多重残疾1.14%(95%CI:1.13%～1.15%)、视力残疾0.99%(95%CI:0.97%～1.01%)、精神残疾0.38%(95%CI:0.37%～0.40%)、智力残疾0.38%(95%CI:0.37%～0.39%)、言语残疾0.12%(95%CI:0.11%～0.13%).遗传、中耳炎、脑瘫、脑疾病(除去原因不明)、智力低下(除去原因不明)是少数民族儿童视力、听力、肢体、智力和言语残疾发生最重要的致残原因.老年性白内障、老年性耳聋、骨关节病、脑血管病和脑梗死是导致少数民族老年人口五类残疾的最重要原因.白内障、中耳炎(除去原因不明)、其他外伤、脑疾病(除去原因不明)是少数民族劳动年龄人口残疾最重要因素.中耳炎造成的儿童听力残疾和不良社会文化因素造成的智力残疾仍然是少数民族人口主要致残因素,其他主要致残因素及其顺位与汉族残疾人口相类似.结论 少数民族人口残疾现患率高于汉族人口,在不同年龄阶段,应针对主要致残因素预防和降低少数民族人群的残疾发生.     

当心你的听力被“偷走”

正据世界卫生组织(WH0)估算,全世界有轻度听力损失者近6亿,中度以上的听力损失者近2.5亿。我国有听力障碍残疾人2780万,居各类残疾之首,占全国人口的16.79%。,其中7岁以下聋幼儿可达80万,每年还将新产生聋儿3万余名,老年性耳聋有949万,随着人口寿命增长和老龄化,老年性耳聋人数将不断增加。听力障碍严重影响着这些人群的     

黑龙江省0～6岁儿童残疾现状及影响因素分析

目的了解黑龙江省0～6岁儿童残疾水平及影响因素,为预防儿童残疾发生、提高残疾儿童生存状态制定相关规划提供依据.方法采取分层、多阶段、整群、概率比例抽样方法,对抽取的样本单位进行入户调查结果 0～6岁残疾儿童总残疾现患率为8.75‰:残疾程度以一、四级为主;农村与城市地区的残疾现患率分别为9.65‰、6.73‰;男童现患率为11.86‰,女童现患率为5.58‰:致残原因以产前因素(50.00%)和原因不明(27.42%)为主;残疾儿童的年龄、性别、母亲是否识字、父母是否有工作是残疾儿童发生的高危因素.结论黑龙江省0～6岁儿童总残疾现患率下降明显,产前因素和原因不明是导致残疾发生的主要原因,需进一步加强孕产期保健及对残疾儿童致病原因的探索研究.     

常州市0～6岁儿童残疾发生情况分析及对策

目的 :了解 2 1世纪初本地区 0～ 6岁儿童中残疾现状 ,为防治儿童残疾和残疾儿童康复服务。方法 :用整群抽样法进行入户调查 ,分析 0～ 6岁儿童的残疾现患率、残疾程度、残疾谱和致残原因。结果 :调查本地区 0～6岁儿童的残疾现患率为 8 6‰ ,智力残疾约占 1/2 ,以下依次为肢体残疾和精神残疾 ;轻度残疾约占 5 0 0 % ,中、重度残疾约各占 2 5 0 % ;残疾原因中 ,出生缺陷、孕期及围产期高危因素和原因不明致残者约各占 1/3。结论 :根据致残原因分别提出了相应对策     

东莞市抽样人群听力调查分析

目的 从流行病学角度了解东莞市抽样人群听力情况.方法 根据第二次全国残疾人抽样调查方案对东莞市八小区共3678人进行听力调查.结果 根据第二次全国残疾人抽样调查方案的听力残疾诊断标准,阳性40人,占总调查人群1.09%,以老年性聋为主.结论 进一步了解了康复需求,为政府职能部门制定耳聋预防及早期干预规划提供了理论依据.     

中国2006年和1987年人群肢体残疾患病率分析

目的 了解中国肢体残疾人群现状及近20年来该人群流行病学特征的改变.方法 对1987年和2006年两次全国残疾人抽样调查结果中肢体残疾调查数据进行现状描述及流行病学特征分析和比较.结果 2006年中国肢体残疾人比1987年增加约1657万人,肢体残疾现患率上升了1.42%.两次抽样调查结果均以轻度肢体残疾人所占比例最大.1987年西藏自治区肢体残疾现患率最高(3.76%),广东省最低(0.64%);2006年北京市肢体残疾现患率最高(3.20%),浙江省最低(1.74%).除西藏自治区肢体残疾现患率下降外,全国肢体残疾现患率均有不同程度的增加,以内蒙古自治区增幅最大.农村人群肢体残疾现患率显著上升,已超过城市.男性肢体残疾现患率仍然高于女性.肢体残疾的年龄别现患率随着年龄增加而增加的趋势没有改变,但不同年龄人群肢体残疾现患率变化差异很大,0～14岁人群肢体残疾现患率仅增加了0.10%,而65岁及以上老年肢体残疾人的现患率却比1987年增加5.35%.结论 20年来中国肢体残疾人口总量增加,现患率上升;华北、东北地区是肢体残疾预防的重点地区;农村人口、男性以及老年人群是肢体残疾预防的重点.     

河南省0~6岁残疾儿童状况调查

目的:了解河南省0~6岁儿童残疾现况。方法:根据第二次全国残疾人抽样调查方案进行实施,应用SAS9.1.3统计学软件对数据进行处理分析。结果:0~6岁儿童残疾现患率为1.79%,其中57.34%为男性残疾儿童,37.44%儿童患多重残疾,14.79%接受了教育,智力残疾占44.72%,言语残疾占23.91%,肢体残疾占13.35%;致残原因主要有原因不明、发育异常、新生儿窒息、早产、产伤、遗传、药物等因素;83.85%未接受任何服务或扶助,81.68%的需要医疗救助。结论:河南省0~6岁儿童残疾状况不容乐观,应针对致残原因采取相应干预措施。     

中国人口六类残疾流行现状

目的 了解2006年中国人口视力、听力、言语、肢体、智力和精神残疾的流行现状.方法 参照<第二次全国残疾人抽样调查残疾标准>,于2006年4月1日0时在31个省、自治区、直辖市抽取2 526 145人进行全国第二次残疾人抽样调查,对6类残疾的流行现状进行分析.结果 (1)全国总现患率为6. 39%,与1987年的4.90%相比,升高1.49个百分点.其中肢体残疾现患率最高,为2.34%;言语残疾最低,为0.53%.(2)全国一、二级重度残疾人占29.49%,三、四级的中度和轻度残疾占70.51%,言语残疾一、二级的重度残疾人所占比例超过65%,精神残疾该比例超过45%,为6类残疾中重度残疾比例最高的两类残疾.(3)年龄、性别、居住地均与6类残疾相关,有统计学意义(P＜0.001).(4)在各类残疾中,先天因素对言语残疾、智力残疾中的作用最大,分别占22.67%和22.41%.结论 从数据分析结果来看,2006年中国残疾人具有以下特点:老年残疾人比例高;残疾等级以中轻度为主,但重度残疾比例不低;农村残疾人比例高和致残原因多元化.     

15～59岁肢体残疾人群致残原因研究

目的 了解15～59岁肢体残疾人群的致残原因现状及近20年来该人群主要致残原因的变化.方法 对1987年和2006年两次全国残疾人抽样调查结果 中15～59岁肢体残疾人群致残原因的调查数据进行流行病学特征分析和比较.结果 2006年我国15～59岁肢体残疾人群的主要致残原因类别为疾病因素、伤害因素、先天性疾病及发育障碍和其他因素,致残率分别为0.720%、0.595%、0.224%和0.186%.其他外伤所致肢体残疾的致残率最高,为0.296%.与1987年调查结果 相比,疾病因素、伤害因素、先天性疾病及发育障碍的致残率均显著上升.2006年我国15～59岁肢体残疾人群的前五位致残原因分别是:其他外伤、脊髓灰质炎、骨关节病、脑血管疾病以及工伤;1987年前五位致残原因分别是:其他外伤、小儿麻痹、其他原因、不明原因和血管性疾病.结论 疾病因素和伤害因素是我国15～59岁肢体残疾人群的主要致残原因类别,其他外伤因素致残率最高;骨关节病和脑血管疾病逐渐成为我国15～59岁肢体残疾人群的主要致残原因.     

中国因伤害导致残疾的流行病学研究

目的 了解中国因伤害导致残疾的流行病学现况.方法 利用2006年第二次全国残疾人抽样调查数据,提取因伤害导致残疾的数据资料进行统计描述与分析,采用聚类分析进行地区间比较.结果 全国因伤害导致残疾的现患率为99.68/万,占总体残疾人的15.59%.残疾类别以肢体残疾最高(65.59%),其次是听力残疾(23.35%)、智力残疾(4.86%)、视力残疾(4.71%)和言语残疾(1.49%).残疾等级以四级、三级为主,分别占到55.14%和25.83%.因伤害导致残疾的现患率在不同年龄组问差异有统计学意义(x2=23 106.14,P＜0.001),年龄越高,因伤害导致残疾的现患率越高.男性高于女性(128.35/万和70.23/万;x2=2161.74,P＜0.001).聚类分析将全国31个省因伤害导致总残疾的现患率分为5类,其中第5类地区(四川)与第4类地区(湖南、重庆、贵州、宁夏)因伤害导致的残疾问题突出.结论 我国因伤害导致残疾人群发生率约为1000/10万.因伤害导致残疾的类别中以肢体残疾和听力残疾为主.高龄、男性的因伤害导致残疾危险增高,不同地区因伤害导致残疾情况不同.     

上海市嘉定区社区老年人的失能现状及其影响因素

  目的  了解上海市嘉定区老年人的失能现状并分析其影响因素,为老年人失能防控和健康老龄化建设提供科学依据。  方法  采用多阶段随机抽样方法,选取≥60岁的嘉定区户籍老年人群作为调查对象,采用世界卫生组织研发的自报健康调查量表测量老年人失能情况;应用多因素Logistic回归分析模型及列线图分析老年人失能的影响因素。  结果  共调查老年人4 773人,其中失能老人495人,失能率为11.4%,女性的失能率(13.6%)高于男性(8.9%)。老年人自我评价在认知记忆、视力辨认、疼痛不适、睡眠及活动行走这五方面存在更多的失能,失能率分别为31.7%、23.0%、21.6%、20.4%和13.6%。多因素分析结果显示,年龄大、自评健康较差、患2种及以上慢性病的老年人失能率较高(均有P＜0.05);每周体育锻炼、饮酒的老年人失能率较低(均有P＜0.05)。  结论  嘉定区社区老年人失能率较高。应加强慢性病管理,关注老年人的不同照护需求,开展针对性的早期预防和干预。     

Prevalence and patterns of multimorbidity among elderly people in rural Bangladesh: a cross-sectional study

Data on multimorbidity among the elderly people in Bangladesh are lacking. This paper reports the prevalence and distribution patterns of multimorbidity among the elderly people in rural Bangladesh. This cross-sectional study was conducted among persons aged > or = 60 years in Matlab, Bangladesh. Information on their demographics and literacy was collected through interview in the home. Information about their assets was obtained from a surveillance database. Physicians conducted clinical examinations at a local health centre. Two physicians diagnosed medical conditions, and two senior geriatricians then evaluated the same separately. Multimorbidity was defined as suffering from two or more of nine chronic medical conditions, such as arthritis, stroke, obesity, signs of thyroid hypofunction, obstructive pulmonary symptoms, symptoms of heart failure, impaired vision, hearing impairment, and high blood pressure. The overall prevalence of multimorbidity among the study population was 53.8%, and it was significantly higher among women, illiterates, persons who were single, and persons in the non-poorest quintile. In multivariable logistic regression analyses, female sex and belonging to the non-poorest quintile were independently associated with an increased odds ratio of multimorbidity. The results suggest that the prevalence of multimorbidity is high among the elderly people in rural Bangladesh. Women and the non-poorest group of the elderly people are more likely than men and the poorest people to be affected by multimorbidity. The study sheds new light on the need of primary care for the elderly people with multimorbidity in rural Bangladesh.     

2007年青岛市黄岛区农村老年人跌落伤害情况调查

[目的]了解青岛市黄岛区农村60岁以上老年人跌落伤害发生情况及相应影响因素,为制定干预策略和政策奠定基础。[方法]2007年9月,在黄岛区农村抽取2 052名60岁以上老年人进行入户调查。[结果]调查2 052人,过去1年发生过跌落的185人,跌落发生率为9.02%。跌落发生率,男性为8.34%,女性为9.64%（P〉0.05）;60-69岁为5.65%,70-79岁为8.38%,80岁以上为14.67%（P〈0.01）。跌落的185人合计跌落201人次（例）,引起皮肤擦伤的占30.35%,软组织挫伤的占16.42%,骨折占12.44%,脱臼占8.46%,脑震荡占5.97%,昏迷占4.48%。[结论]黄岛区农村老年人跌落发生率较低,但由此引起的伤害较严重。     

社会参与因素对听力障碍者心理健康的影响

目的比较听力障碍人群与正常人群心理结构的不同及社会参与因素对心理健康的影响。方法采用WHO/PDH97.3推荐的耳聋残疾标准,用GVSLN-TC-GK2000型听觉评估仪测两耳听阈,对筛选出的154例18岁以上听力障碍者分别进行心理健康和社会适应能力测试,并以78例普通听力正常人作为对照组。比较两组人群的心理健康状况(SCL-90量表)和社会适应能力(SSRS量表),并分析社会参与因素对心理健康状况的影响。结果 154例听力障碍者SCL-90量表总分为161.95±48.75,多项因子分值高于听力正常者(P0.01);心理问题阳性项目数为39.45±15.28,检出率为57.6%,高于对照组(P0.05);社会支持总分为36.15±5.53,低于听力正常者(P0.05)。年龄(OR=2.21,2.66)、城乡(OR=1.96,1.78)、家庭经济状况(OR=4.52,3.22)、听力残疾级别(OR=3.77,2.74)是听力障碍者社会适应能力和心理健康的共有危险因素。经单因素Logistic回归分析,听力障碍者社会参与与心理健康状况显著相关(P0.05)。结论听力障碍者心理健康状况比正常人差,社会参与与心理健康状况显著相关。     

Causes of death of adults and elderly and healthcare-seeking before death in rural Bangladesh

The health system of a country needs to be adjusted to patterns of morbidity and mortality to mitigate the income-erosion consequences of prolonged ill-health and premature death of adults. Population-based data on mortality by cause are a key to modifying the health system. However, these data are scarce, particularly for rural populations in developing countries. The objectives of this study were to determine the burdens of health due to major causes of death obtained from verbal autopsy of adults and the elderly and their healthcare-seeking patterns before death in a well-defined rural population. There were 2,397 deaths--613 were among adults aged 15-59 years and 1,784 among the elderly aged 60+ years--during 2003-2004 in the health and demographic surveillance area in Matlab, a rural area of Bangladesh. Trained interviewers interviewed close relatives of the deceased using a structured verbal-autopsy questionnaire to record signs and symptoms of diseases/conditions that led to death and medical consultations before death. Two physicians independently assigned the underlying causes of deaths with disagreements resolved by a third physician. The physicians were able to assign a specific cause in 91% of the cases. Rates and proportions were used for estimating the burden of diseases by cause. Of all deaths of adults and the elderly, communicable diseases accounted for 18% and non-communicable diseases for 66%, with the proportion of non-communicable diseases increasing with age. Leading non-communicable diseases were diseases of the circulatory system (35%), neoplasms (11%), diseases of the respiratory system (10%), diseases of the digestive system (6%), and endocrine and metabolic disorders (6%), all of which accounted for 68% of deaths. Injury and other external causes accounted for another 5% of the deaths. During terminal illness, 31% of the adults and 25% of the elderly sought treatment from medical doctors, and 14% of the adults and 4% of the elderly died in healthcare facilities. The findings suggest that the health managers and policy-makers of Bangladesh should recognize the importance of prevention and management of chronic diseases and place it on the health agenda for rural people.     

Economic evaluation of disability prevention programs for community-dwelling elderly secular trend analyses of medical and care expenses comparing participants and non-participants in the programs

OBJECTIVE: This study was conducted to evaluate disability prevention programs for community-dwelling elderly in terms of the cost/benefit balance. METHODS: Out of all residents aged 65 years and over who lived in Yoita Town, Niigata Prefecture, Japan (n = 1,673), 1,544 persons participated in the baseline survey conducted in November, 2000 (response rate, 92.2%). Based on the results, Yoita town then launched several kinds of disability prevention programs for community-dwelling elderly, e.g., preventive programs for falls, dementia and homeboundness. The subjects for the present study included only those aged 70 years and over who responded to the baseline survey and were alive as of March 2004. During 2001 to 2003, 146 persons had participated at lease once in one of disability prevention programs (denoted as the participant group), whereas 846 persons had not participated in any of the programs (denoted as the non-participant group). We compared medical and care expenses (sum of national and employment health insurance benefits, and long-term care insurance) between the two groups during 2000-2003, and determined whether participating in program affected subsequent medical and care expenses independent of key confounders [sex, age, and baseline medical and care expenses or health indicator (TMIG-Index of Competence or Generic Mobility Index)], using general linear models. RESULTS: The mean medical expenses per capita and per month slightly decreased over the period of the study in the participant group (51,606 yen for 2000 to 47,539 yen for 2003), while those in non-participant group steadily increased (41,888 yen, to 51,558 yen, respectively). During the same period, the mean care cost per capita and per month increased in both groups, but the increase was much more moderate in the participating group (507 yen to 5,186 yen vs. 8,127 yen to 27,072 yen for non-participant group). Summed cost reduction through the program participation accounted for 49 million yen during the three years (2001-2003). After adjustment for sex, age and baseline medical and care expenses or health indicator, it was estimated as 12 million yen per year. Given that the expenses for the disability prevention programs summed 2.3 million yen per year, the net benefit of disability prevention programs was estimated to be approx. 10 million yen per year. CONCLUSION: Disability preventive programs for the community-dwelling elderly are economically efficient in terms of the cost/benefit balance. Future research is needed to examine how such programs lead to cost reduction.     

老年躯体疾病与抑郁症的调查分析

目的 调查基层社区老年人躯体疾病患病情况;探讨基层社区老年躯体疾病与抑郁症的关联性,为制订防治措施提供科学依据.方法 对某基层社区60岁以上老年人进行调查并将自评健康、躯体患病以及健康恶化情况分别进行单因素的患病率分析.结果 躯体疾病患病率最高的前4位依次是：①视觉障碍（62.2%）、听觉障碍（47.0%）、高血压（40.1%）、慢性支气管炎（6.7%）.②老年抑郁症的患病率情况.结论 ①基层社区老年人视觉障碍、听觉障碍、高血压、慢性支气管炎、糖尿病等躯体疾病患病率较高,要加强防治工作;②具有患抑郁症因素老年人,应及早预防抑郁症发生.     

2018年武汉市老年人跌倒伤害及其影响因素

目的探讨武汉市老年人跌倒现状和影响因素,为预防老年人跌倒提供科学依据。方法通过问卷调查和健康体检收集2018年武汉市65岁以上老年人免费体检数据387 476条,采用SAS 9.4软件进行描述性分析、χ^2检验和多因素Logistic回归分析。结果 2018年老年人跌倒报告率为3.44%,城市(4.42%)高于农村(2.39%),女性(4.22%)高于男性(2.47%);家中是老年人跌倒的好发地点(占46.48%);最常见的跌倒伤害性质为扭伤/拉伤(占31.07%);多因素分析表明,跌倒的主要危险因素有女性,轻中度依赖的生活自理能力,运动能力减弱-双手不能放脑后、不能捡起地上物品,骨关节疾病,眼部疾病,脑卒中(均有P<0.05)。结论 2018年武汉市65岁以上老年人过去一年内跌倒伤害的报告率为3.44%,生活自理能力减弱、运动能力减弱、患骨关节疾病、眼部疾病、脑卒中是老年人跌倒的重要危险因素。