城市老年人健康状况相关因素初步探讨

调查老年人的综合健康功能状况,并了解物质、文化、精神生活以及影响老年人健康的各因素,有利于指导老年人更好地生活. 资料与方法:调查对象为上海市静安区一个街道中一个居委会60周岁及以上的老年人266例,其中男110例、女156例,年龄60～91岁.     

原发性高血压患者自评健康状况及影响因素

目的 了解原发性高血压患者自评健康状况及其影响因素。方法 利用卫生行业科研专项“心血管疾病监测、预防预警和诊治技术应用研究”项目中高血压患者43 264例的基线数据进行分析。询问调查对象觉得自己的健康状况如何,根据所提供选项分为好、较好、一般、较差、很差五个类别。采用logistic回归对其自评健康状况影响因素进行分析。结果 高血压患者自评健康状况一般占52.00%、较好占33.35%、好占9.55%、较差占4.80%、很差占0.30%。多因素logistic回归分析结果显示,相对于自评健康状况一般,使用网络、月收入>1 000～3 000元、>3 000～5 000元(与≤1 000元比较)和饮酒者自评健康状况为好(包括好和较好)的可能性高,而自评健康状况为差(包括较差和很差)的可能性低;丧偶、2～3级高血压、糖尿病、心绞痛、脑卒中、心肌梗死、一过性脑缺血、不良情绪以及合并疾病数量≥1种者自评健康状况为差的可能性高,而自评健康状况为好的可能性低。结论 丧偶、2～3级高血压、合并其他疾病及不良情绪将导致高血压患者自我健康评价不良;有使用网络、月收入>1 000～5 0...     

北京老年人躯体功能的变化状况及其影响因素

目的 观察在社区中老年群体的功能转变情况．并分析其可能影响因素。方法 在1992年的基线调查时日常生活活动全部自理的60岁以上老人．1994年对同一样本再次调查，比较前后功能衰退情况，并进行单因素及多因素分析。结果 1992年时日常生活活动全部自理的60岁以上老人2522人，1994年共追踪到2377人，其中240人死亡；101人日常生活活动能力下降，共有341人(14.3％)功能衰退，转变为非健康生活状态。这种转变随年龄增高呈线性增长，单因素分析提示：社会经济状况、婚姻、家庭生活、营养情况、健康自评、心境水平等因素都是影响功能衰退的潜在因素。多因素分析则表明．影响最大的是增龄，其次是操作性日常生活活动能力有障碍、健康自我评价差及既往有脑卒中病史发生功能衰退的机率较高。此外营养状况、家庭生活情况和心理卫生水平也有着不可忽视的作用。而化程度、职业、社会经济状况、婚姻等指标主要通过一些间接的影响而发生作用。结论 要搞好老年保健，预防老年人功能衰退应采取综合性措施。     

威海市老年人自感健康状况及其影响因素的分析

目的了解威海市老年人(60～100岁)自感健康状况及其影响因素。方法利用分层整群随机抽样方法对威海市4个市区老年人自感健康状况进行基线调查,并用SPSS13.0对其影响因素进行分析。结果老年人自感健康状况和身体状况相一致,且受性别、年龄、婚姻状况、受教育程度、卫生服务需求和利用及心理健康状况的影响。结论明确了影响威海市老年人自感健康状况的因素,为做好老年人的心理卫生保健工作,提高老年人的健康水平和生活质量,提供了依据。     

北京市老年人躯体功能评价与影响因素分析

目的：评价北京市老年人躯体功能状况，分析影响老年人生活自理能力的危险因素。方法：采用按类分层、随机、整群等距的抽样方法，于1992年抽样调查了城区、郊区及山区55岁以上3257人，1997年进行了随访。老年人生活自理能力评价采用WHO日常生活活动能力量表。结果：北京市老年人群生活安全自理者2079人（74.6％），有IADL功能障碍（轻度生活依赖）531人（19.1％），ADL功能障碍（中重度依赖）176人（6.3％），总依赖率25.4％（标化依赖率19.1％）。农村地区及女性老年人的依赖率高，随增龄依赖率呈线性增高。5年纵向观察显示，老年躯体功能呈双向变化，大部分（73.9％）保持稳定，17.3％功能减退，8.8％的老人功能改善。功能减退的主要原因系慢性病所致，脑卒中是导致功能障碍的最主要疾病，同时也受其他因素如生物、心理、文化、甚至环境因素的影响。结论：积极防治老年常见病，预防功能残疾是减少老年人躯体功能衰退的关键。     

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.     

老年人生存质量的影响因素

随着世界各国经济文化水平的不断提高,人们的生活水平也得到不断改善,预期寿命随之延长。目前世界上不论是发达国家还是发展中国家,老年人口都在不断增加,特别是日本、北美和欧洲的一些国家,老年人口的增长速度比其他任何一个年龄组都高。据世界人口状况报告,全世界每年新增老龄人口接近900万,比世界新增人口数量的10％略少。到2010～2015年,这一数字将增加到每年1450.4万。目前世界新增老年人口有77％来自发展中国家,2015年还将增到80％以上。到2045～2050年,世界总人口每年增加不足5000万,其中97％将来源于今天的发     

贵州省舟溪乡老年人的家庭及健康状况调查

1989年对贵州省凯里市舟溪乡的1274名60岁以上老人进行家庭及健康调查。结果显示:老年人的经济生活水平较低,慢性病的患病率颇高,但老人对经济生活普遍感到满意,子女对老人尊敬,老人们的晚年生活一般是幸福的。最后,对如何制定老龄政策作了讨论。     

南京市老年人健康自评及影响因素分析

目的 探讨老年自评健康状况及其影响因素.方法 采用整群随机抽样方法对600人进行调查,通过Ordinal Logistic回归方法对影响老年人自评健康的因素进行分析和比较.结果 92.2％的老年人自评健康为“一般”以上,其中慢性病患病情况、社会功能、家庭和睦程度、日常锻炼情况对老年人的自评健康有显著的影响(P＜0.05).结论 老年人自评健康主要受患慢性病状况、社会功能、家庭和睦程度、日常锻炼的影响,说明和谐的家庭环境、良好的社会关系和适当的锻炼对老年人的健康有较好的促进作用.     

银川市城区65岁以上老年人日常生活功能评价及影响因素的研究

目的 探讨银川市65岁以上老年人的日常生活功能状况及其影响因素。方法 采用单纯随机和整群抽样的方法对银川市城区5个街道中10个居委会内65岁以上的634名老年入进行了调查，运用日常生活功能指数、Logistic回归等方法综合分析了银川市城区老年人的日常生活功能及影响因素。结果 12项日常生活活动的丧失率随活动的复杂和困难程度的增高而上升；其丧失率随年龄的增加而增高；控制了年龄的作用后，活动的复杂和困难程度越大，经济收入、性别间的差异越大，女性高于男性(P＜0．05)；与下肢活动有关项目(如爬楼梯、站立2h)的丧失率较高；老年人的日常生活功能在不同年龄、性别、婚姻、受教育程度、就业史、对退休工资的满意程度、参加体育锻炼之间有显著性差异(P＜0．05)。结论 躯体健康是影响老年人日常生活功能最主要的因素；同时还受心理因素、社会因素、人口因素的影响。     

Development of a home visitation programme for the early detection of health problems in potentially frail community-dwelling older people by general practices

The integration within existing health care systems of preventive initiatives to maintain independent living among older people is increasingly emphasized. This article describes the development and refinement of the [G]OLD home visitation programme: an eight-step programme, including a comprehensive geriatric assessment, for the early detection of health and well-being problems among older people (≥75 years) by general practices. A single group post-test study using a mixed model design is performed to evaluate (a) the feasibility of the home visitation programme in general practice, (b) the practical usefulness of the geriatric assessment instrument, and (c) programme implementation with respect to reinventions introduced by general practitioners (GPs) and practice nurses (PNs). Within 3 months time, 22 PNs of 18 participating general practices visited 240 community-dwelling older people (mean age = 82.0 years; SD 4.2) who had not been in contact with their general practice for more than 6 months. Mean time investment of the programme per older person was 118.1 min (SD 27.0) for GPs and PNs combined. Evaluation meetings revealed that GPs and PNs considered the home visitation programme to be feasible in daily practice. They judged the geriatric assessment to be useful, although minor adjustments are needed (e.g., lay-out, substitution of tests). PNs often failed to register follow-up actions for detected problems in a care and treatment plan. Future training for PNs should address this issue. No reinventions were introduced that threatened fidelity of implementation. The findings are used to improve the home visitation programme before its evaluation in a large-scale controlled trial.     

Assessment and management of hearing loss in older people in Belgium,Portugal and Turkey

Hearing loss, usually due to presbycusis, is frequent in old age and goes often undetected or untreated. Older subjects with hearing loss have increasing communication problems, reduced quality of life, isolation, depression and also feelings of frustration and discouragement. Hearing loss is also linked to cardiovascular problems, depression and dementia. Despite its relevance, country-level epidemiological data on age-related incidence and prevalence of presbycusis are limited, and no specific data in different geriatric settings are usually available. Population screening programs similar to those in infants are not widely implanted, although both primary care providers and geriatricians have incorporated strategies to detect hearing loss. No guidelines are available on when and how to screen and manage hearing loss in old age. Management of presbycusis is usually directed by ENT specialists, in cooperation with audiologist. These may be hospital-based or work in for profit centres, depending on the country. Funding of hearing aids by health care providers is limited, so some patients do not have access to them due to their high cost. Attitudes towards hearing loss, including considering it an inevitable age-related problem, may also limit access to care. Cochlear implants are still anecdotal in older patients in most countries. There is still a long way to go in the detection and management of hearing loss in older people. Systematic screening, careful assessment and treatment guidelines will have to be developed and implemented, both at country and European level.     

Surgery for large bowel cancer in people aged 75 years and older

Three hundred ten predominantly male patients who were 75 years of age or older and had surgery for colorectal carcinoma had a hospital mortality rate of 9 percent and a cancer-related five-year survival of 50 percent. These results and a detailed analysis of the causes of complications and mortality were compared with the outcome of 710 patients who were treated concurrently and who were younger than 75 years. Tumors in older patients had a tendency to occur on the right side and were more locally advanced. Increased mortality was particularly attributable to sepsis and cardiovascular causes. Increased morbidity was due principally to respiratory and urinary problems. There were no significant differences, however, in wound or anastomotic complications, nor was therapy for the older patients more costly. The indications for surgical resection for colorectal cancer in patients aged 75 years and older should be the same as those for any younger group. Read at the XIth Biennial Congress of the International Society of University Colon and Rectal Surgeons, May 4 to 8, 1986, Dallas, Texas. Supported by the Department of Veterans' Affairs and Telmak Pfy., Ltd.     

老年低保人员心理卫生干预效果评价

目的 评价老年低保人员心理干预措施的效果,以期找到对该人群进行心理干预的方法.方法 采用分层整群抽样的方法抽取徐州市老年低保人员112人为调查对象,并选取112名非低保人员进行1∶1配对.将低保人员分为干预组和对照组,对干预组实施心理干预.干预方法主要有心理健康讲座、心理咨询和心理剧治疗等.使用SCL-90量表进行心理卫生状况调查并评价心理干预效果.结果 SCL-90量表评分显示老年低保人员9个因子分均高于非低保人员,心理卫生状况较差.实施心理干预后,干预组的人际关系敏感[(1.13±0.39)与(1.26±0.26),t=2.12,P=0.04]、忧郁[(1.23±0.66)与(1.43±0.24),t=2.08,P=0.04]、焦虑[(1.18±0.50)与(1.38±0.34),t=2.17,P=0.03]、敌对[(1.24±0.49)与(1.40±0.28),t=2.03,P=0.04]和其他项目[(1.31±0.56)与(1.49±0.31),t=2.04,P=0.04]5个因子分及总得分[(115.89±17.21)与(122.64±10.41),t=2.42,P=0.02]均低于对照组.结论 通过实施社区综合心理干预,老年低保人员心理卫生问题得到一定程度的改善.     

Geriatric assessment in the elderly cancer patient

Lost and remaining functions are of special importance in geriatric medicine. The level of functional deficits ultimately determines the remaining quality of life and the patient's ability to continue independently. In contrast, the actual severity of a disease measured by common standards becomes less important. Geriatric assessment is increasingly used to describe the impact of disease and to focus on the functional losses and problems that are particularly relevant to the individual elderly patient. When developing a treatment plan for older cancer patients, it is essential to consider the functional deficits caused by age-related changes or comorbidity, the remaining compensation mechanisms and the patient's expectations. Cancer treatment has to be adapted to the individual needs of elderly patients. As the number of cancer patients is rising in all areas of medical practice, a close collaboration between oncologists and geriatricians will become increasingly important. Received: 12 January 2000 / Accepted: 25 January 2000     

Oral condition and health status of people aged 80–85 years

Objectives:   To clarify the relationship between oral condition and health status, particularly bone mineral density (BMD), in the elderly aged 80 years or more.
Methods:   We examined the oral conditions and health status of two groups. One was elderly who lived at home and had at least 20 teeth at the age of 80 (8020 elderly). The other group consisted of elderly people residing in long-term care facilities (institutionalized elderly). The oral conditions we examined were the number of teeth, masticatory ability, occlusal force, stimulated salivary flow rate, saliva buffer ability, community periodontal index (CPI) and salivary occult blood test. The health status indicators we examined were BMD, grip strength, height, weight and body mass index (BMI).
Results:   The number of teeth, stimulated salivary flow rate, masticatory ability, and occlusal force in the 8020 elderly were significantly higher than in the institutionalized elderly. BMD, grip strength, height, weight and BMI in these 8020 elderly were also significantly higher than in the institutionalized elderly. Masticatory ability and occlusal force in the institutionalized elderly with high BMD (high BMD group) were significantly higher than in the institutionalized elderly with low BMD (low BMD group). Grip strength, height and weight in the high BMD group were higher than in the low BMD group.
Conclusions:   The 8020 elderly had good oral condition and health status compared to the institutionalized elderly. There may be a relationship between number of teeth and BMD in elderly aged 80–84.     

2004年和2005年河北省三河市地方性氟中毒监测结果报告

目的了解河北省三河市地方性氟中毒（简称地氟病）防治效果及降氟设施使用情况。方法按《全国地方性氟中毒重点监测方案》对三河市100个改水工程的使用情况进行调查；对三河市燕郊镇赵辛庄村和皇庄镇皇庄村进行地氟病病情监测，儿童氟斑牙检查用Dean法，水氟、尿氟测定采用氟离子选择电极法。结果三河市100个集中式改水设施，饮水含氟量在1．0mg／L以下的仅有54个，占54％。2004、2005年燕郊镇赵辛庄村水氟均值分别为0．53、0．45mg／L，8～12岁儿童氟斑牙检出率分别为19．5％、21．7％，儿童尿氟分别为1．51、1．15mg／L；皇庄镇皇庄村水氟均值分别为0．57、0．68mg／L，8～12岁儿童氟斑牙检出率分别为26．7％、24．5％，儿童尿氟分别为1．41、1．38mg／L。结论三河市2个地氟病病区村的饮水含氟量均符合国家标准．8～12岁儿童氟斑牙检出率等主要监测指标已降至非病区水平，监测点氟中毒病情得到有效控制。