Changes in living arrangements and mortality among older people in China.
Changes in living arrangements and mortality among older people in China.
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DOI：
10.1016/j.ssmph.2016.11.009
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Vlachantoni A
中科院分区：
文献类型：
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作者：
Feng Z;Falkingham J;Liu X;Vlachantoni A
晚年的生活安排是动态的，随着生活事件的变化，如丧偶或进入机构。以前的研究发现，生活安排的特定变化与死亡风险的增加有关。然而，尽管中国是世界上老年人口最多的国家，但在中国范围内对这一领域的研究有限。本研究利用2002 - 2011年中国健康长寿纵向调查数据，探讨了居住安排的变化对老年人生存的影响。2002年的原始样本为16,064人，本研究包括2005年幸存的6191人，这些人在后来的几波中有完整的记录。审查了2002年至2005年期间生活安排的变化。然后使用考克斯比例风险模型来调查2005年至2011年生活安排动态与受访者生存状况之间的关联。结果表明，2002年和2005年都住在机构里的男女，或从与家人住在一起搬到机构里的男女，与继续与家人住在一起的人相比，面临更大的死亡风险。相比之下，继续与家人生活或独自生活，或在与家人生活和独自生活之间移动，与死亡风险增加无关，尽管性别有一些差异。中国的机构护理行业仍处于起步阶段，其提供基于支付市场费用的能力，而不是与年龄相关的功能障碍相关的需求。研究结果表明，居住或迁入机构与高死亡风险相关，因此需要在快速变化的中国社会背景下进行进一步调查。研究生活安排的变化与生存状态之间的关系。入住和入住机构的老年人死亡风险更高。从机构搬到社区的老年男子死亡率更高。独居的老年妇女死亡率较高。
Living arrangements in later life are dynamic, with changes associated with life events such as widowhood or moves into an institution. Previous research has found particular changes in living arrangements to be associated with an elevated risk of mortality. However, research in this area within the context of China is limited, despite China being home to the world's largest population of older people. This study investigates the impact of changes in living arrangements on older persons’ survival using the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2011. The original sample was 16,064 in 2002, and this study includes 6191 individuals who survived in 2005 and had complete information of track record in later waves. Changes in living arrangements are examined between 2002 and 2005. Cox-proportional hazards models are then used to investigate the association between the dynamics of living arrangements and respondents’ survival status from 2005 to 2011 . Results show that men and women who lived in an institution in both 2002 and 2005, or who moved into an institution from living with family faced a greater risk of dying compared to those continuing to live with family. By contrast, continuing to live with family or alone, or moving between living with family and living alone, were not associated with an increased mortality risk, although there were some differences by gender. The institutional care sector in China is still in its infancy, with provision based on ability to pay market fees rather than need associated with age-related function impairment. The findings show that living in, or moving into, an institution is associated with a high mortality risk therefore requires further investigation in the context of a rapidly changing Chinese society. Examines the association between changes in living arrangements and survival status. Higher mortality risk for elderly people who stay in and move into an institution. Higher mortality for older men who move from an institution to the community. Higher mortality for older women who move to living alone.