我国老年人健康相关行为对慢性病共病的影响研究
Study on the Influence of Health-Related Behaviors on Chronic Disease Comorbidity in Elderly People in China

目的：探讨我国老年人健康行为对慢性病共病的影响并利用关联规则探索共病模式，为制定健康相关行为预防策略提供参考依据。方法：基于中国老年健康影响因素跟踪调查(CLHLS)中10,747名65岁老年人的相关数据，利用多因素logistic回归模型分析健康生活相关行为对慢性病共病的影响；通过关联规则分析慢性病共病组合。结果：研究对象 ≥ 65岁共计10,381名，慢性病共病患病率为36.04%。基于睡眠质量、睡眠时间、健康饮食、无吸烟史、无饮酒史、锻炼以及户外社交活动等7个健康生活相关行为变量的得分，分为健康行为组别人群3023人(29.12%)和不健康行为组别7358人(70.88%)。多因素logistic回归分析结果显示，年龄组别为65~74岁(OR = 1.16, 95%CI: 1.02~1.32)和75~84岁人群(OR = 1.56, 95%CI: 1.40~1.74)、户籍为城市(OR = 2.50, 95%CI: 2.26~2.75)人群是慢性病共病的危险因素。男性、学历组别为文盲和小学、正常BMI以及健康行为是慢性病共病的保护因素。不同健康行为组别的共病组合存在差异。健康生活方式与慢性病共病低风险相关，从健康行为上对老年人加以引导和宣传并加强常见共病模式慢性病的筛查与预防不失为有效降低慢性病共病的途径。
Objective: To explore the influence of health behaviors on chronic disease comorbidities among elderly in China and the comorbidity patterns using association rules, to provide a reference for formulating health-related behavior prevention strategies. Methods: Based on the data of 10,747 65-year-old elderly people in the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a multivariate logistic regression model was used to analyze the influence of healthy life-related behaviors on chronic disease comorbidities. The combination of chronic diseases comorbidities was analyzed by association rules. Results: There were 10,381 subjects ≥ 65 years old, and the prevalence of chronic diseases was 36.04%. Based on the scores of 7 behavioral variables related to a healthy life, including sleep quality, sleep time, healthy diet, no smoking history, no drinking history, exercise, and outdoor social activities, the population was divided into 3023 people (29.12%) in the healthy behavior group and 7358 people (70.88%) in the unhealthy behavior group. Multivariate logistic regression analysis showed that the age group of 65~74 years old (OR = 1.16, 95%CI: 1.02~1.32) and 75~84 years old population (OR = 1.56, 95%CI: 1.40~1.74), and the household registration of urban (OR = 2.50, 95%CI: 2.26~2.75) were risk factors for chronic disease comorbidity. Male, educational group illiteracy and primary school, normal BMI, and healthy behaviors were protective factors for chronic disease comorbidities. The comorbidities of different health behavior groups were different. A healthy lifestyle is associated with a low risk of chronic disease comorbidities. It is an effective way to reduce chronic disease comorbidities by guiding and propagandizing the elderly from health behaviors and strengthening the screening and