社区居家物质环境对中老年人衰弱影响追踪研究
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南京邮电大学

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国家社会科学基金


Impact of the community-based home physical environment on frailty among middle-aged and older adults: a longitudinal study
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Nanjing University of Posts and Telecommunications

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The National Social Science Fund of China

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    摘要:

    利用中国健康与养老追踪调查2011—2020年数据,对5776名基线时年龄为45岁及以上、衰弱指数<0.25的非衰弱中老年人进行追踪研究。运用Cox混合效应模型,进行中老年人衰弱的影响因素分析。结果表明:①1863人(32.3%)在9年随访期间发生衰弱,发生衰弱人群更多表现为居住在平房、没有自来水、缺乏洗浴设施、使用固体燃料、室内整洁度较低、社区活动场所较少。②高评分的健身设施与较低的衰弱发生风险存在稳健的负向关联。交互作用与亚组分析显示有显著的群体差异:高水平的居住质量对有伴侣及1951—1966年出生队列起保护作用;健身设施的保护作用具有较为广泛的群体一致性,与吸烟状况存在交互修饰作用;社会文化设施的保护效益则呈现城乡非均衡特征,主要集中在农村群体中。研究结果反映了未来老年友好型社会环境改造应大力推动社区健身设施建设,并特别关注脆弱群体。

    Abstract:

    Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, this study followed 5,776 non-frail middle-aged and older adults aged 45 and above with a baseline frailty index < 0.25, using Cox mixed-effects models to examine the determinants of frailty onset. The results indicated that: (1) a total of 1,863 individuals (32.3%) developed frailty during the 9-year follow-up, and participants who progressed to frailty were more likely to reside in single-story houses, lack running water and bathing facilities, rely on solid fuels, maintain lower indoor cleanliness, and have access to fewer community activity venues; (2) higher physical fitness facility scores exhibited a robust negative association with frailty risk. Interaction and subgroup analyses revealed significant population heterogeneities where high-quality housing conditions exerted a protective effect primarily among partnered individuals and the 1951–1966 birth cohort, the protective benefit of fitness facilities demonstrated broad consistency while showing a significant interaction effect with smoking status, and socio-cultural facilities displayed marked urban-rural disparities by predominantly benefiting rural populations. In conclusion, these findings suggest that future age-friendly environmental renovations should prioritize the expansion of community fitness facilities while implementing targeted interventions for vulnerable populations.

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  • 收稿日期:2026-08-24
  • 最后修改日期:2026-10-10
  • 录用日期:2026-10-12
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