社会经济因素对高龄老年人临终前生活自理能力衰退过程的影响

以《中国老年人健康长寿影响因素调查》数据为基础,利用混合线性增长模型,分析了1998—2014年七期调查中已经死亡的老年人样本在临终前的生活自理能力变化轨迹,以及童年期、成年期和老年期的社会经济因素对其生活自理能力变化过程的影响。研究发现,这三个时期的社会经济因素会对老年人临终前的生活自理能力衰退过程产生直接和间接的影响。早期较差的社会经济状况会通过死亡的选择作用提高进入老年期个体的生活自理能力表现,这种机制不会影响个体的生活自理能力变化轨迹,但是会间接降低失能人群的照料成本;丰富的社会经济资源会通过改善老年个体的内在能力和功能表现发挥对生活自理能力的保护作用,这种保护作用可以降低老年人的失能风险和照料成本,也会增加失能人群的死亡风险和照料成本,多种机制的共同作用增加了老年人失能风险变化趋势的不确定性。

Effects of Socioeconomic Factors on Decline Process of Self-care Ability of the Elderly before the Death

Based on the data of The Longitudinal Survey on the Influencing Factors of Health and Longevity of the Elderly in China,using the mixed linear growth model,this paper analyzes the life self-care ability change track of the dead elderly samples in the seven period survey from 1998 to 2014,and the influence of the social and economic factors in childhood,adulthood and old age on their life self-care ability change process.It is found that the socioeconomic factors in these three periods will have direct and indirect effects on the decline of the elders ability to take care of themselves before they die.Poor social and economic conditions in the early stage will improve the performance of self-care ability of individuals entering the old age through the selective role of death.This mechanism will not affect the change track of self-care ability of individuals,but will indirectly reduce the cost of care for the disabled;rich social and economic resources will also play the role of self-care through improving the internal ability and functional performance of the elderly individuals.The protective effect can reduce the risk of disability and the cost of care;it can also affect the risk of death of the disabled and increase the cost of care.The combined effect of various mechanisms increases the uncertainty of the trend of disability risk in the elderly.