Abstract: Background   At present，the elderly are the focus group of the nationwide health construction.However，disability seriously affects the physical and mental health of the elderly.Some studies have found that chronic diseases may be associated with disability in the elderly，but most of these studies are cross-sectional studies，which have certain limitations in determining the relationship between chronic diseases and disability.Objective  To study the relationship between chronic diseases and disability in the elderly with in-home care，providing a scientific basis for the prevention and control of disability in this group.Methods  A community population-based，1∶2 matched case-control study was conducted between October and December 2016 in a sample of 201 older people aged ≥60 years receiving in-home care，including 67 rated as disabled by the Activities of Daily Living Scale（ADLs），and 134 age- and sex-matched non-disabled.Multivariate conditional Logistic regression analysis was used to investigate the relationship between chronic diseases and disability.Results  After controlling for confounders，Logistic regression analysis results showed that subjects with chronic diseases had a 2.494 times higher risk of disability than those without〔95%CI （1.274，4.881）〕.Subjects with 2 or more chronic diseases had a 3.113-fold increased risk of disability〔95%CI（1.425，6.802）〕compared with those with 1 chronic disease or without.Sex-stratified analysis showed that stroke〔OR=9.750，95%CI（1.099，86.532）〕 and hypertension〔OR=3.402，95%CI （1.077，10.746）〕were found to increase the risk of disability in older men.Conclusion  Disability of the elderly with in-home care is associated with chronic diseases.Strengthening the prevention and control of hypertension and cerebral apoplexy plays an important role in reducing the incidence of disability in the elderly especially older men.

Key words: Health services for the aged, Aged, Chronic disease, Disability, Case-control studies

摘要： 背景  目前老年人是我国全民健康建设重点人群，然而失能严重影响了老年人的身心健康。研究发现慢性病与老年人失能可能有关联，而这些研究多是横断面研究，在确定慢性病与失能的关系中存在一定的局限。目的  探讨居家老年人慢性病与失能的关系，为居家老年人失能的防控提供科学依据。方法  于2016年10—12月采用以社区人群为基础按1∶2比例进行年龄、性别匹配的病例对照研究。病例组为调查样本人群中经日常生活活动能力量表（ADLs）评定为失能者67例，对照组为同期人群中符合匹配条件的未失能者134例。采用多因素条件Logistic回归分析慢性病与失能的关系。结果  在控制混杂因素后，Logistic回归分析结果显示，患有慢性病者发生失能的风险是未患者的2.494倍〔95%CI（1.274，4.881）〕；患≥2种慢性病者发生失能的风险是患≤1种慢性病者的3.113倍〔95%CI（1.425，6.802）〕。按性别分层后，发现患脑卒中〔OR=9.750，95%CI（1.099，86.532）〕和高血压〔OR=3.402，95%CI（1.077，10.746）〕会使男性老年人发生失能的风险增加（P<0.05）。结论  居家老年人失能与慢性病有关。有针对性地加强高血压和脑卒中防控对降低老年人尤其是老年男性失能的发生有重要作用。

关键词: 老年人保健服务, 老年人, 慢性病, 失能, 病例对照研究