关键词: 失能, 老年人, 综合能力, 河南, 数据收集, 影响因素分析

Abstract: Background　The 14th Five-Year Plan period （2021—2025） is a rapid stage of aging，and a crucial development period of aging-related industries and elderly care system in China.Henan Province has a large elderly population with urgent demand for elderly care services.Objective　To investigate the prevalence and influencing factors of comprehensive disability in the elderly in Henan Province.Methods　This survey was implemented from January to September 2019.By use of multi-stage stratified cluster random sampling，adults aged 60 and above were selected from Henan Province for a survey.They were asked to fill in questionnaires Demographic Information Form developed by our research team and the Ability Assessment for Older Adults（MZ/T039-2013） onsite.For those who could not write，investigators did that for them after acquiring relevant information via a detailed interview.Ordinal and multinomial logistic regressions were used to identify factors associated with disability.Results　Altogether，5 570 of the 6 014 cases who gave effective responses to the survey were finally enrolled.Among them，the prevalence of intact comprehensive ability，and different levels of comprehensive disability was 49.55%（2 760/5 570），and 50.45%（2 810/5 570），respectively.To be specific，the prevalence of mild，moderate and severe disability was 41.14% （2 291/5 570），6.10%（340/5 570） and 3.21%（179/5 570），respectively.The prevalence of disability in activity of daily living，mental status，sensory and communication，and social involvement was 20.45% （1 139/5 570），35.89% （1 999/5 570），23.34% （1 300/5 570），and 19.48% （1 085/5 570），respectively.The level of comprehensive disability varied significantly by sex，age，place of residence，education level，living status，income，developmental physical or mental disability，dementia prevalence，mental illness prevalence and the prevalence of accidental events within 30 days prior to the survey （P<0.05）.Logistic regression analyses found that age〔60~ years old：OR=0.115，95%CI（0.075，0.177）；70~ years old：OR=0.154，95%CI（0.101，0.236）；80~ years old：OR=0.323，95%CI（0.209，0.498）〕，education level〔Illiterate / semi illiterate：OR=2.911，95%CI（2.337，3.626）；primary school：OR=1.873，95%CI（1.519，2.310）；junior middle school：OR=1.545，95%CI（1.244，1.918）〕，living status〔live alone：OR=0.521，95%CI（0.373，0.727）；living with spouse：OR=0.452，95%CI（0.338，0.604）；living with children：OR=0.534，95%CI（0.396，0.719）〕，income〔0~：OR=2.306，95%CI（1.172，4.539）；4 001~：OR=2.939，95%CI（1.340，6.444）〕，prevalence of developmental physical or mental disability〔OR=0.257，95%CI（0.214，0.310）〕，dementia prevalence〔OR=0.030，95%CI（0.022，0.041）〕，mental illness prevalence 〔OR=0.190，95%CI（0.126，0.286）〕and the prevalence of accidental events within 30 days prior to the survey〔OR=0.163，95%CI（0.134，0.198）〕 were associated with the level of comprehensive disability （P<0.05）.Conclusion　The prevalence of comprehensive disability in older adults in Henan Province was over than 50%，and mild comprehensive disability made up the largest percentage.Age，education level，living status，income，developmental physical or mental disability，dementia，mental illness，and accidents within the past 30 days influenced the level of comprehensive disability.

Key words: Disability, Elderly, Comprehensive ability, Henan, Data collection, Root cause analysis