Abstract: Background　Degenerative disorders of physical functions increase susceptibility to diseases. Affected by various chronic diseases，the elderly lose their ability to take care of themselves in daily life, even lead to varying degrees of disability. With the aging and increase of average life expectancy of the Chinese population，the number of elderly people with disability is increasing. Objective　To evaluate the disability in community-dwelling elderly people with different chronic diseases，providing a basis for the delivery of countermeasures. Methods　From July 2016 to January 2017，a multi-stage stratified cluster random sampling method was used to randomly select 1 out of 8 secondary hospitals and 8 tertiary hospitals in Tangshan City，Hebei Province. The elderly（≥60 years old）in all the community health service centers（stations）under the jurisdiction of these two hospitals were selected as the subjects. A household survey was conducted for collecting sociodemographic characteristics and prevalence of chronic diseases（stroke，arthritis/rheumatism，hypertension，diabetes，heart disease，osteoporosis，depression） and the disability in the elderly with a questionnaire consisting of 3 parts〔sociodemographic data，prevalence of chronic diseases，and a 14-item Activities of Daily Living （ADL）〕. In this study，the total score of ADL is 14-56，and individuals with ADL scores of 14，greater than 14 but less than 22，equal to or greater than 22 are defined as independent，mild disability，severe disability，respectively. Logistic regression analysis was conducted to analyze the associated factors for the disability in the elderly. Results　Of the 6 342 participants，6 171 responded to the study questionnaire，giving a response rate of 97.30%. Among the respondents，the prevalence rates of independent，mild disability and severe disability，were 59.67%（3 682/6 171），21.73%（1 341/6 171），and 18.60%（1 148/6 171），respectively. The overall prevalence of disability was 40.33% （2 489/6 171）．Logistic regression analysis found that age，education level，marital status，chronic diseases（stroke，diabetes，heart disease，osteoporosis，depression） were the influencing factors of disability in community-dwelling elderly people （P<0.05）．Conclusion　Chronic disease aggravates the level of disability in community-dwelling elderly people. In view of this，elderly people with chronic disease are suggested to seek treatment actively in order to reduce of the possibility of having disability and to relieve the burden of care.

Key words: Health services for the aged, Community health services, Chronic disease, Disability, Root cause analysis

摘要： 背景　老年人身体状况呈退行性变化，对疾病的易感性也随之增加。受各种慢性病的影响，老年人日常生活自理能力不同程度地丧失，甚至导致不同程度的失能。随着我国人口老龄化及人口平均预期寿命的增长，失能老年人数量呈现日益上升的趋势。目的　了解罹患慢性病社区老年人失能状况，为采取应对措施提供依据。方法　于2016年7月—2017年1月，采用多阶段分层整群随机抽样法在河北省唐山市市区内的8所二级医院、8所三级医院中分别随机抽取1所，抽取此2所医院所有直属社区卫生服务中心（站）所管辖社区内的老年人（≥60岁）为研究对象，调查其社会人口学特征及慢性病（脑卒中、关节炎/风湿病、高血压、糖尿病、心脏病、骨质疏松症、抑郁症）罹患情况，采用日常生活能力量表（ADL）测评其失能程度，ADL总分为14~56分，14分为无失能，>14分且<22分为轻度失能，≥22分为重度失能。采用Logistic回归分析社区老年人失能的影响因素。结果　共发放问卷6 342份，回收有效问卷6 171份，有效回收率为97.30%。其中3 682例（59.67%）为无失能，1 341例（21.73%）为轻度失能，1 148例（18.60%）为重度失能，失能率为40.33%。Logistic回归分析结果显示：年龄、文化程度、婚姻状况、有无罹患慢性病（脑卒中、糖尿病、心脏病、骨质疏松症、抑郁症）是社区老年人失能的影响因素（P<0.05）。结论　罹患慢性病加重社区老年人失能程度，积极治疗慢性病，有助于降低老年人的失能率，减轻照护者照护负担。

关键词: 老年人保健服务, 社区卫生服务, 慢性病, 失能, 影响因素分析