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Article(id=1322165041453969983, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322164984558243894, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.01.011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1743177600000, receivedDateStr=2025-03-29, revisedDate=1763395200000, revisedDateStr=2025-11-18, acceptedDate=null, acceptedDateStr=null, onlineDate=1793158310520, onlineDateStr=2026-10-28, pubDate=1767974400000, pubDateStr=2026-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793158310520, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793158310520, creator=13701087609, updateTime=1793158310520, updator=13701087609, issue=Issue{id=1322164984558243894, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='1', pageStart='1', pageEnd='176', issueExtLink='null', onlineDate='null', pubDate='1767974400000', pubDateStr='2026-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793158296955, creator='13701087609', updateTime=1793158296955, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=84, endPage=89, ext={EN=ArticleExt(id=1322165043001668160, articleId=1322165041453969983, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Correlation between social activity level and risk of frailty in older adults: a prospective cohort study, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between social activity level and the risk of frailty among older adults in China.

Methods

This older adults aged ≥60 years without frailty were selected from the CHARLS database.A baseline survey was conducted in 2013,with follow-ups on frailty occurrence in 2015 and 2018. Poisson regression was used to analyze the impact of social activity level on frailty incidence.Subgroup analyses were further conducted based on gender,alcohol consumption, and life satisfaction.

Results

A total of 3 287 older adults were included,with a frailty incidence of 19.17%.After controlling for variables such as age,gender,marital status,education level,and smoking status,older adults with a high level of social activity had a 34.9% lower risk of frailty compared to those with low to moderate levels[RR=0.651,95%CI(0.545,0.778)].Subgroup analysis showed that,except for older adults dissatisfied with their lives,where the association between social activity level and frailty risk was not statistically significant,the risk of frailty was significantly reduced in older adults with high social activity levels across different genders,alcohol consumption status,and those satisfied with their lives(P<0.05).

Conclusions

A high level of social activity is an important protective factor in delaying the onset of frailty.Additionally,we should pay attention to psychological and social changes in male older adults,those who consume alcohol,and those with high life satisfaction,so as to helping them build strong social networks and provide psychological interventions when necessary.

, authors=Ying YAN, Linlin ZHANG, authorsList=Ying YAN, Linlin ZHANG, authorCompany=null, correspAuthors=Linlin ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Linlin, E-mail:
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目的

探究我国老年人群社交活跃度与衰弱发生风险的关系。

方法

选取中国健康与养老追踪调查（CHARLS）中年龄≥60岁且基线调查未发生衰弱的老年人为研究对象，于2013年开展基线调查，于2015年和2018年随访衰弱发生情况。采用Poisson回归分析社交活跃度对衰弱发生风险的影响，并对性别、饮酒情况、生活满意度进一步进行亚组分析。

结果

共纳入3 287名老年人，衰弱发生率为19.17%；在控制年龄、性别、婚姻状况、文化程度、吸烟情况等变量后，与中低水平社交活跃度的老年人相比，高水平社交活跃度老年人发生衰弱的风险降低34.9%［RR=0.651，95%CI（0.545，0.778）］。亚组分析显示，除对生活不满意的老年人的社交活跃度与衰弱的发生风险关联无统计学意义外，在不同性别、饮酒情况、对生活满意的老年人群中，相较于中低水平社交活跃度的老年人，高水平社交活跃度老年人衰弱的发生风险均降低（P<0.05）。

结论

高水平的社交活跃度是延缓老年人衰弱发生的重要保护因素。此外，应对男性、饮酒以及对生活满意度高的老年人在心理、社会等方面的变化予以重视，为其构建良好的社交网络，必要时进行心理干预。

, authors=严莹, 张琳琳*, *, authorsList=严莹, 张琳琳, authorCompany=null, correspAuthors=张琳琳, authorNote=

严莹，硕士研究生

, correspAuthorsNote=
张琳琳，E-mail：
ZHANG Linlin, E-mail:
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tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=S1, pageStart=142, pageEnd=149, url=null, language=null, rfNumber=16, rfOrder=15, authorNames=CHU W-M, NISHITA Y, TANGE C, journalName=Geriatrics & Gerontology International, refType=null, unstructuredReference=CHU W-M,NISHITA Y,TANGE C,et al.Effects of cigarette smoking and secondhand smoke exposure on physical frailty development among community-dwelling older adults in Japan:evidence from a 10-year population-based cohort study[J].Geriatrics & Gerontology International,2024,24(S1):142-149., articleTitle=Effects of cigarette smoking and secondhand smoke exposure on physical frailty development among community-dwelling older adults in Japan:evidence from a 10-year population-based cohort study, refAbstract=null), Reference(id=1322529779853677248, tenantId=1146029695717560320, journalId=1220038315760373764, 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unstructuredReference=王琼,刘晨,侯晓春,等.社会参与类型对老年人认知功能的影响研究[J].中国预防医学杂志,2023,24(7):632-636., articleTitle=社会参与类型对老年人认知功能的影响研究, refAbstract=null), Reference(id=1322529779975312066, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, doi=null, pmid=null, pmcid=null, year=2024, volume=53, issue=9, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=SOLTANI S, JAYEDI A, GHOREISHY S, journalName=Age and Ageing, refType=null, unstructuredReference=SOLTANI S,JAYEDI A,GHOREISHY S,et al.Alcohol consumption and frailty risk:a dose-response meta-analysis of cohort studies[J].Age and Ageing,2024,53(9):afae199., articleTitle=Alcohol consumption and frailty risk:a dose-response meta-analysis of cohort studies, refAbstract=null), Reference(id=1322529780038226627, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, doi=null, pmid=null, pmcid=null, year=2023, volume=27, issue=7, pageStart=1368, pageEnd=1376, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=LU N, ZHANG J Y, journalName=Aging & Mental Health, refType=null, unstructuredReference=LU N,ZHANG J Y.A multiple-group analysis of social capital and loneliness among community-dwelling older adults in urban China during the outbreak of the COVID-19 pandemic[J].Aging & Mental Health,2023,27(7):1368-1376., articleTitle=A multiple-group analysis of social capital and loneliness among community-dwelling older adults in urban China during the outbreak of the COVID-19 pandemic, refAbstract=null), Reference(id=1322529780105335492, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, doi=null, pmid=null, pmcid=null, year=2021, volume=15, issue=5, pageStart=567, pageEnd=573, url=null, language=null, rfNumber=21, rfOrder=20, authorNames=HOLT-LUNSTAD J, journalName=American Journal of Lifestyle Medicine, refType=null, unstructuredReference=HOLT-LUNSTAD J.Loneliness and social isolation as risk factors:the power of social connection in prevention[J].American Journal of Lifestyle Medicine,2021,15(5):567-573., articleTitle=Loneliness and social isolation as risk factors:the power of social connection in prevention, refAbstract=null), Reference(id=1322529780168250053, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=1, pageStart=235, pageEnd=null, url=null, language=null, rfNumber=22, rfOrder=21, authorNames=ANZAI S, OHSUGI H, SHIBA Y, journalName=BMC Geriatrics, refType=null, unstructuredReference=ANZAI S,OHSUGI H,SHIBA Y.Factors associated with social participation among community-dwelling frail older adults in Japan:a cross-sectional study[J].BMC Geriatrics,2024,24(1):235., articleTitle=Factors associated with social participation among community-dwelling frail older adults in Japan:a cross-sectional study, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322529772748526221, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, xref=1, ext=[AuthorCompanyExt(id=1322529772756914830, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, companyId=1322529772748526221, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Medical and Health Engineering, Changzhou University, Jiangsu 213000 China), AuthorCompanyExt(id=1322529772769497743, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, companyId=1322529772748526221, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1常州大学医学与健康工程学院，江苏 213000)])], figs=[ArticleFig(id=1322529776754086568, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=EN, label=Table 1, caption=

Comparison of baseline characteristics between frail and non-frail older adults

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类衰弱组(n=630)未衰弱组(n=2 657)统计值P
社交活跃度[例（%）]中低水平509(80.8)1 834(69.0)χ2=34.453<0.001
高水平121(19.2)823(31.0)
年龄（岁）68(64,74)65(62,70)Z=-7.653<0.001
性别[例（%）]男258(41.0)1 435(54.0)χ2=34.754<0.001
女372(59.0)1 222(46.0)
文化程度[例（%）]小学及以下572(90.8)2 105(79.2)
初中/高中/中专55(8.7)512(19.3)χ2=45.288<0.001
专科及以上3(0.5)40(1.5)
婚姻状况[例（%）]有配偶488(77.5)2 218(83.5)χ2=12.672<0.001
无配偶142(22.5)439(16.5)
吸烟[例（%）]从不404(64.1)1 495(56.3)
曾经27(4.3)115(4.3)χ2=13.6600.001
现在199(31.6)1 047(39.4)
饮酒[例（%）]从不388(61.6)1 400(52.7)
曾经80(12.7)311(11.7)χ2=22.608<0.001
现在162(25.7)946(35.6)
BMI[例（%）]偏瘦59(9.4)172(6.5)
正常327(51.9)1 444(54.3)χ2=6.6490.036
超重/肥胖244(38.7)1 041(39.2)
生活满意度[例（%）]满意542(86.0)2 434(91.6)χ2=18.479<0.001
不满意88(14.0)223(8.4)
ADL受限[例（%）]未受限489(77.6)2 407(90.6)χ2=81.764<0.001
受限141(22.4)250(9.4)
慢性病数量[例（%）]未患病126(20.0)917(34.5)
1种211(33.5)843(31.7)χ2=57.156<0.001
2种及以上293(46.5)897(33.8)
), ArticleFig(id=1322529776837972649, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=CN, label=表1, caption=

衰弱组与未衰弱组老年人基线资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类衰弱组(n=630)未衰弱组(n=2 657)统计值P
社交活跃度[例（%）]中低水平509(80.8)1 834(69.0)χ2=34.453<0.001
高水平121(19.2)823(31.0)
年龄（岁）68(64,74)65(62,70)Z=-7.653<0.001
性别[例（%）]男258(41.0)1 435(54.0)χ2=34.754<0.001
女372(59.0)1 222(46.0)
文化程度[例（%）]小学及以下572(90.8)2 105(79.2)
初中/高中/中专55(8.7)512(19.3)χ2=45.288<0.001
专科及以上3(0.5)40(1.5)
婚姻状况[例（%）]有配偶488(77.5)2 218(83.5)χ2=12.672<0.001
无配偶142(22.5)439(16.5)
吸烟[例（%）]从不404(64.1)1 495(56.3)
曾经27(4.3)115(4.3)χ2=13.6600.001
现在199(31.6)1 047(39.4)
饮酒[例（%）]从不388(61.6)1 400(52.7)
曾经80(12.7)311(11.7)χ2=22.608<0.001
现在162(25.7)946(35.6)
BMI[例（%）]偏瘦59(9.4)172(6.5)
正常327(51.9)1 444(54.3)χ2=6.6490.036
超重/肥胖244(38.7)1 041(39.2)
生活满意度[例（%）]满意542(86.0)2 434(91.6)χ2=18.479<0.001
不满意88(14.0)223(8.4)
ADL受限[例（%）]未受限489(77.6)2 407(90.6)χ2=81.764<0.001
受限141(22.4)250(9.4)
慢性病数量[例（%）]未患病126(20.0)917(34.5)
1种211(33.5)843(31.7)χ2=57.156<0.001
2种及以上293(46.5)897(33.8)
), ArticleFig(id=1322529776913470122, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=EN, label=Table 2, caption=

Variable assignments

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
衰弱未衰弱=0，衰弱=1
社交活跃度中低水平=0，高水平=1
性别男=0，女=1
文化程度小学及以下（0，0），初中/高中/中专（1，0），专科及以上（0，1）
婚姻状况有配偶=0，无配偶=1
吸烟情况从不（0，0），曾经（1，0），现在（0，1）
喝酒情况从不（0，0），曾经（1，0），现在（0，1）
BMI偏瘦（0，0），正常（1，0），超重/肥胖（0，1）
生活满意度不满意=0，满意=1
ADL受限状况未受限=0，受限=1
患慢性病数量未患病（0，0），1种（1，0），2种及以上（0，1）
年龄原值输入
), ArticleFig(id=1322529776988967595, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=CN, label=表2, caption=

变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
衰弱未衰弱=0，衰弱=1
社交活跃度中低水平=0，高水平=1
性别男=0，女=1
文化程度小学及以下（0，0），初中/高中/中专（1，0），专科及以上（0，1）
婚姻状况有配偶=0，无配偶=1
吸烟情况从不（0，0），曾经（1，0），现在（0，1）
喝酒情况从不（0，0），曾经（1，0），现在（0，1）
BMI偏瘦（0，0），正常（1，0），超重/肥胖（0，1）
生活满意度不满意=0，满意=1
ADL受限状况未受限=0，受限=1
患慢性病数量未患病（0，0），1种（1，0），2种及以上（0，1）
年龄原值输入
), ArticleFig(id=1322529777081242284, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=EN, label=Table 3, caption=

Results of Poisson regression analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类回归系数标准误Wald χ2值PRR值95%CI
年龄0.0400.00649.565<0.0011.041[1.029,1.052]
性别男1.000
女0.2890.1028.0270.0051.336[1.093,1.632]
文化程度小学及以下1.000
初中/高中/中专-0.5430.13516.173<0.0010.581[0.446,0.757]
专科及以上-0.9820.5293.4410.0640.375[0.133,1.057]
婚姻状况有配偶1.000
无配偶-0.0250.0910.0740.7860.975[0.815,1.167]
吸烟情况从不1.000
曾经0.1410.1790.6190.4311.152[0.810,1.637]
现在0.0460.0990.2130.6451.047[0.862,1.270]
饮酒情况从不1.000
曾经-0.0270.1150.0550.8140.973[0.778,1.218]
现在-0.1620.0962.8700.0900.850[0.705,1.026]
BMI偏瘦1.000
正常-0.0980.1240.6220.4300.907[0.712,1.156]
超重/肥胖-0.0810.1290.3890.5330.922[0.716,1.189]
生活满意度满意1.000
不满意0.3430.09912.0580.0011.409[1.161,1.709]
ADL受限情况无受限1.000
受限0.6100.08354.248<0.0011.840[1.564,2.164]
患慢性病数量未患病1.000
1种0.4550.10219.901<0.0011.576[1.291,1.925]
2种及以上0.7060.09753.091<0.0012.026[1.675,2.449]
社交活跃度中低水平1.000
高水平-0.4290.09122.254<0.0010.651[0.545,0.778]
), ArticleFig(id=1322529777152545453, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=CN, label=表3, caption=

Poisson回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类回归系数标准误Wald χ2值PRR值95%CI
年龄0.0400.00649.565<0.0011.041[1.029,1.052]
性别男1.000
女0.2890.1028.0270.0051.336[1.093,1.632]
文化程度小学及以下1.000
初中/高中/中专-0.5430.13516.173<0.0010.581[0.446,0.757]
专科及以上-0.9820.5293.4410.0640.375[0.133,1.057]
婚姻状况有配偶1.000
无配偶-0.0250.0910.0740.7860.975[0.815,1.167]
吸烟情况从不1.000
曾经0.1410.1790.6190.4311.152[0.810,1.637]
现在0.0460.0990.2130.6451.047[0.862,1.270]
饮酒情况从不1.000
曾经-0.0270.1150.0550.8140.973[0.778,1.218]
现在-0.1620.0962.8700.0900.850[0.705,1.026]
BMI偏瘦1.000
正常-0.0980.1240.6220.4300.907[0.712,1.156]
超重/肥胖-0.0810.1290.3890.5330.922[0.716,1.189]
生活满意度满意1.000
不满意0.3430.09912.0580.0011.409[1.161,1.709]
ADL受限情况无受限1.000
受限0.6100.08354.248<0.0011.840[1.564,2.164]
患慢性病数量未患病1.000
1种0.4550.10219.901<0.0011.576[1.291,1.925]
2种及以上0.7060.09753.091<0.0012.026[1.675,2.449]
社交活跃度中低水平1.000
高水平-0.4290.09122.254<0.0010.651[0.545,0.778]
), ArticleFig(id=1322529777244820142, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=EN, label=Table 4, caption=

Subgroup analysis of the impact of different levels of social activity on incidence of frailty in older adults

, figureFileSmall=null, figureFileBig=null, tableContent=
项目亚组RR值[95%CI]P
性别男0.494[0.353,0.691]<0.001
女0.755[0.611,0.933]0.009
饮酒从不0.748[0.606,0.923]0.007
曾经0.557[0.305,1.017]0.057
现在0.467[0.314,0.693]<0.001
生活满意度满意0.609[0.500,0.742]<0.001
不满意1.016[0.672,1.536]0.940
), ArticleFig(id=1322529778490528431, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322165041453969983, language=CN, label=表4, caption=

不同社交活跃度对老年人衰弱发生影响的亚组分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目亚组RR值[95%CI]P
性别男0.494[0.353,0.691]<0.001
女0.755[0.611,0.933]0.009
饮酒从不0.748[0.606,0.923]0.007
曾经0.557[0.305,1.017]0.057
现在0.467[0.314,0.693]<0.001
生活满意度满意0.609[0.500,0.742]<0.001
不满意1.016[0.672,1.536]0.940
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老年人社交活跃度与衰弱发生风险的相关性：一项前瞻性队列研究
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严莹 , 张琳琳 *, *
护理研究 | 科研论著 2026,40(1): 84-89
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护理研究 |科研论著 2026 , 40 (1) : 84 -89
老年人社交活跃度与衰弱发生风险的相关性：一项前瞻性队列研究
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严莹, 张琳琳*, *
作者信息
  • 1常州大学医学与健康工程学院，江苏 213000
通讯作者:
张琳琳，E-mail：
ZHANG Linlin, E-mail:
作者简介:

严莹，硕士研究生

Correlation between social activity level and risk of frailty in older adults: a prospective cohort study
Ying YAN, Linlin ZHANG
Affiliations
  • 1School of Medical and Health Engineering, Changzhou University, Jiangsu 213000 China
    • Corresponding Author:
    ZHANG Linlin, E-mail:
出版时间: 2026-01-10 doi: 10.12102/j.issn.1009-6493.2026.01.011
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摘要
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目的

探究我国老年人群社交活跃度与衰弱发生风险的关系。

方法

选取中国健康与养老追踪调查（CHARLS）中年龄≥60岁且基线调查未发生衰弱的老年人为研究对象，于2013年开展基线调查，于2015年和2018年随访衰弱发生情况。采用Poisson回归分析社交活跃度对衰弱发生风险的影响，并对性别、饮酒情况、生活满意度进一步进行亚组分析。

结果

共纳入3 287名老年人，衰弱发生率为19.17%；在控制年龄、性别、婚姻状况、文化程度、吸烟情况等变量后，与中低水平社交活跃度的老年人相比，高水平社交活跃度老年人发生衰弱的风险降低34.9%［RR=0.651，95%CI（0.545，0.778）］。亚组分析显示，除对生活不满意的老年人的社交活跃度与衰弱的发生风险关联无统计学意义外，在不同性别、饮酒情况、对生活满意的老年人群中，相较于中低水平社交活跃度的老年人，高水平社交活跃度老年人衰弱的发生风险均降低（P<0.05）。

结论

高水平的社交活跃度是延缓老年人衰弱发生的重要保护因素。此外，应对男性、饮酒以及对生活满意度高的老年人在心理、社会等方面的变化予以重视，为其构建良好的社交网络，必要时进行心理干预。

老年人  /  衰弱  /  社交活跃度  /  影响因素  /  生活满意度  /  饮酒  /  队列研究
Objective

To explore the relationship between social activity level and the risk of frailty among older adults in China.

Methods

This older adults aged ≥60 years without frailty were selected from the CHARLS database.A baseline survey was conducted in 2013,with follow-ups on frailty occurrence in 2015 and 2018. Poisson regression was used to analyze the impact of social activity level on frailty incidence.Subgroup analyses were further conducted based on gender,alcohol consumption, and life satisfaction.

Results

A total of 3 287 older adults were included,with a frailty incidence of 19.17%.After controlling for variables such as age,gender,marital status,education level,and smoking status,older adults with a high level of social activity had a 34.9% lower risk of frailty compared to those with low to moderate levels[RR=0.651,95%CI(0.545,0.778)].Subgroup analysis showed that,except for older adults dissatisfied with their lives,where the association between social activity level and frailty risk was not statistically significant,the risk of frailty was significantly reduced in older adults with high social activity levels across different genders,alcohol consumption status,and those satisfied with their lives(P<0.05).

Conclusions

A high level of social activity is an important protective factor in delaying the onset of frailty.Additionally,we should pay attention to psychological and social changes in male older adults,those who consume alcohol,and those with high life satisfaction,so as to helping them build strong social networks and provide psychological interventions when necessary.

older adults  /  frailty  /  social activity level  /  influencing factors  /  life satisfaction  /  alcohol consumption  /  cohort study
严莹, 张琳琳. 老年人社交活跃度与衰弱发生风险的相关性：一项前瞻性队列研究. 护理研究, 2026 , 40 (1) : 84 -89 . DOI: 10.12102/j.issn.1009-6493.2026.01.011
Ying YAN, Linlin ZHANG. Correlation between social activity level and risk of frailty in older adults: a prospective cohort study[J]. Chinese Nursing Research, 2026 , 40 (1) : 84 -89 . DOI: 10.12102/j.issn.1009-6493.2026.01.011
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目前，我国已全面进入人口老龄化阶段，据统计，截至2024年末，我国60岁及以上老年人口数高达31 031万人，占全国总人口的22.0%[1]。老年人的机体功能随着年龄增长而逐渐下降，从而引起器官或功能退行性改变，呈现出复杂的健康状况。一项长期追踪调查发现，老年人衰弱前期的发生率为40.3%~42.1%，衰弱发生率为23.9%~40.8%[2]。衰弱作为一种多维度的健康缺损状态，主要表现为老年人生理机能储备降低、机体易损性增加，导致抗应激能力减退[3]。衰弱会引起老年人肌肉质量下降、运动功能减弱、负性情绪增多，进而削弱其社会参与和社交互动的积极性[4]。而有研究表明，高水平的社交活动作为衰弱的保护因素，可以显著提升老年人的健康水平，在一定程度上延缓衰弱的发生[5]。但以往研究多为横断面研究，仅限于对衰弱现状及影响因素特征的描述，本研究采用中国健康与养老追踪调查(CHARLS)2013—2018年的纵向跟踪数据，探讨我国老年人社交活动与衰弱发生风险之间的关系，为延缓老年人衰弱的发生、提高老年人健康水平提供依据。
1　对象与方法
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1.1　研究对象
研究对象来自2013年、2015年及2018年CHARLS数据库。该数据库是在北京大学国家发展研究院支持下，针对全国范围内150个县区、450个村级单位开展的大规模、多学科交叉的调查项目，以获得具有代表性的中老年人群的相关数据。研究对象纳入标准：1）年龄≥60岁；2）2013年基线调查未发生衰弱。排除标准：1）重要条目缺失；2）失访数据。本研究纳入2013年60岁及以上且未发生衰弱的老年人6 519人，排除衰弱变量数据缺失1 134人，失访数据2 098人，最终纳入有效样本量3 287人。CHARLS项目已通过北京大学伦理审查委员会批准（审批号：IRB00001052-11015）。
1.2　方法
1.2.1　基线资料收集
1）人口学因素：包括年龄、性别、婚姻状况、文化程度。2）生活方式因素：包括吸烟情况、饮酒情况、生活满意度、体质指数（BMI）、日常生活活动能力(activities of daily living,ADL)受限情况。3）患慢性病数量：慢性病包括高血压、血脂异常、糖尿病或高血糖、癌症或恶性肿瘤、慢性肺部疾病、肝病、心脏病、脑卒中、肾病、胃或其他消化系统疾病、情绪及神经或精神问题、记忆力相关疾病、关节炎或风湿病、哮喘[6]。
1.2.2　观察变量与测量工具
1.2.2.1　自变量
以社交活跃度作为自变量。社交活跃度的测量采用CHARLS收集的受访者过去1个月内参与11项社交活动的类型及频率构建社交活跃度指标。社交活动类型包括“串门、跟朋友交往”“打麻将、下棋、去社区活动室”“向与您不在一起的亲人、朋友或邻居提供帮助”“跳舞、健身、练气功等”“参加社团组织活动”“志愿者活动或慈善活动”“照顾与您不住在一起的病人或残疾人”“上学或参加培训课程”“炒股（基金及其他金融证券）”“上网”“其他”共11项。针对每项社交活动，二分编码为0（没有）或1（有）；针对社交活动频率，编码为1（不经常）、2（差不多每周）、3（差不多每天）[7]。两者相乘得出每种社交活动的得分，再将11项社交活动得分相加得到总得分，得分≤2分为中低水平社交活跃度，得分>2分为高水平社交活跃度[8]。
1.2.2.2　因变量
以是否发生衰弱作为因变量。使用衰弱指数(frailty index,FI)评估老年人的衰弱程度。本研究从问卷中选取身体机能、心理健康水平、认知功能3个维度，共纳入36个项目构建衰弱指数。采用慢性病情况、视听能力、自评健康、日常活动能力和移动能力评价老年人的身体机能情况；采用抑郁量表(CESD)评价老年人的心理健康水平；采用记忆测验得分和定向测验得分评价老年人的认知功能，计算公式为：认知功能得分=（记忆测验得分+定向测验得分）/14。衰弱指数的计算公式为：衰弱指数=当前健康损害总和/36；若缺失的项目<4，衰弱指数=有效项目的总数/各自健康损害之和[9]，衰弱指数越高表明衰弱程度越重，本研究将衰弱指数≥0.25定义为衰弱。
1.2.2.3　协变量
以人口学因素、生活方式因素及患慢性病数量作为协变量。生活方式变量中吸烟和饮酒情况包括从不、曾经和现在3个选项；生活满意度包括满意和不满意2个选项；BMI<18.5 kg/m2为偏瘦，BMI为18.5~<24.0 kg/m2为正常，BMI≥24.0 kg/m2为超重或肥胖；ADL包括进食、穿衣、床椅转移、如厕、洗澡和控制大小便6项活动，任何1项有执行困难定义为ADL受限[10]。
1.2.3　统计学方法
采用Stata 17.0软件进行数据合并与样本筛选，使用SPSS 26.0软件进行数据分析。不符合正态分布的定量资料以中位数、四分位数[M(P25,P75)]表示，组间比较采用Wilcoxon秩和检验；定性资料以人数、百分比（%）表示，组间比较采用χ2检验。应用Poisson回归对社交活跃度和衰弱进行分析；采用相乘交互作用分析协变量与社交活跃度对衰弱发生影响的交互作用，并对有交互作用的协变量分别进行亚组分析。以P<0.05为差异有统计学意义。
2　结果
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2.1　老年人的基线特征
本研究共纳入3 287名老年人，其中男1 693人，女1 594人；男性老年人年龄66(63,71)岁，女性老年人年龄65(62,71)岁。3 287名老年人中，630名(19.17%)老年人最终发生衰弱；其中，中低水平社交活跃度的老年人中509人发生衰弱，发生率为21.7%；高水平社交活跃度的老年人中121人发生衰弱，发生率为12.8%。衰弱组与未衰弱组社交活跃度、年龄、性别、文化程度、婚姻状况、吸烟情况、饮酒情况、BMI、生活满意度、ADL受限情况及患慢性病数量比较，差异均有统计学意义(P<0.05)。具体见表1。
2.2　社交活跃度对老年人衰弱发生风险的影响
对自变量和因变量赋值（见表2），进行Poisson回归分析。结果显示，社交活跃度是老年人衰弱发生的影响因素；与中低水平社交活跃度的老年人相比，高水平老年人发生衰弱的风险降低34.9%[RR=0.651,CI(0.545,0.778)]。同时，衰弱的发生风险与年龄、性别、文化程度、生活满意度、ADL受限状况、慢性病数量相关(P<0.05)，见表3。
2.3　亚组分析
相乘交互作用分析结果显示，性别、饮酒、生活满意度与社交活跃度对衰弱发生的影响存在交互作用(P交互<0.001)，年龄、文化程度、婚姻状态、吸烟、BMI、ADL受限情况、患慢性病数量与社交活跃度对衰弱影响的交互作用无统计学意义(P交互>0.05)。分别按性别、饮酒状况、生活满意度进行亚组分析，结果显示，在男性老年人群中，相较于中低水平社交活跃度的老年人，高水平社交活跃度的老年人发生衰弱的风险降低50.6%[RR=0.494,95%CI(0.353,0.691),P<0.001]；而在女性人群中，与中低水平社交活跃度的老年人相比，高水平社交活跃度的老年人发生衰弱的风险降低24.5%[RR=0.755,95%CI(0.611,0.933),P=0.009]。在从不饮酒的老年人群中，相比于中低水平社交活跃度的老年人，高水平社交活跃度的老年人发生衰弱的风险降低了25.2%[RR=0.748,95%CI(0.606,0.923),P=0.007]；对于现在饮酒的老年人群，与中低水平社交活跃度的老年人相比，高水平社交活跃度的老年人发生衰弱的风险降低53.3%[RR=0.467,95%CI(0.314,0.693),P<0.001]；而曾经饮酒的老年人的社交活跃度与衰弱的发生风险的关联无统计学意义[RR=0.557,95%CI(0.305,1.017),P=0.057]。在对生活满意的人群中，相比于中低水平社交活跃度的老年人，高水平社交活跃度的老年人发生衰弱的风险降低39.1%[RR=0.609, 95%CI(0.500,0.742),P<0.001]；而对生活不满意的老年人的社交活跃度与衰弱发生风险的关联无统计学意义[RR=1.016,95%CI(0.672,1.536)，P=0.940]，见表4。
3　讨论
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3.1　社交活动是老年人衰弱发生的影响因素
研究结果显示，社交活动是衰弱的影响因素，高水平的社交活跃度会使衰弱的发生风险降低34.9%，与国内外研究结果[11-12]一致。韩国学者Jang等[12]揭示了较高的社会活动参与度对衰弱的缓解作用是低社会参与度的1.17倍。为了解释这一现象，从生理路径来看，社交活动处于低水平时，可激活下丘脑-垂体-肾上腺素轴和交感神经系统，进而促进骨髓中单核细胞的生成，导致未成熟的促炎性单核细胞的增殖，促使单核细胞从脾脏转出，同时社会隔离会致使糖皮质激素抵抗、促炎基因表达上调以及免疫细胞分泌细胞因子增加，使得炎症和氧化应激增强，进而引发衰弱[13]。从行为路径来看，社交活动对健康促进行为存在显著作用，社交活跃度低的人群更易出现吸烟、饮酒、缺乏运动等不良生活习惯，而这些不良生活习惯是衰弱发生的重要影响因素[14]。本研究对吸烟、饮酒因素进行了调整，结果显示社交活跃度可能通过饮酒影响衰弱的发生，但与吸烟的关系无统计学意义。而Fu等[15]基于国家健康与营养调查（NHANES）数据库的研究发现，老年人接触二手烟与衰弱发生风险呈正相关，这可能是因为二手烟比主动吸烟危害更大，主动吸烟对衰弱的影响仅见于男性，而二手烟暴露对吸烟者和非吸烟者发生衰弱均具有累加效应[16]。而本研究只测量了老年人主动吸烟的情况，未考虑其周围环境暴露于二手烟的情况。由此可见，高水平社交活动作为衰弱的保护因素，可通过生理机制调节和健康促进行为两方面影响衰弱的发生发展。与此同时，日常生活中医务人员应关注老年人周围环境中二手烟的暴露情况。
3.2　社交活跃度对不同性别、饮酒和生活满意度老年人衰弱发生风险的影响
3.2.1　性别
性别亚组分析发现，高水平的社交活跃度对降低男性老年人衰弱风险的程度明显大于女性。Katayama等[17]在探讨社交活动与衰弱的关系中也有类似的发现，这可能与性别相关的社会角色演变有关，男性在青壮年时期构建了较为复杂的社交网络关系，但进入老年阶段后，社交网络发生巨大变化，由此引发的心理适应性压力更为突出；而保持高水平的社交活跃度能够帮助老年人排解孤独无力感，保持健康的心理状态和良好的认知功能，从而降低衰弱的发生风险。而女性由于传统的家庭分工模式导致其长时间参与家庭事务，导致社交娱乐的时间和方式有限，因此，相比于男性，社交活动对女性老年人的正向影响较弱[18]。
3.2.2　饮酒
饮酒亚组分析发现，社交活跃度对现在饮酒的老年人衰弱的发生有影响，这可能是因为60岁以上的老年人正处于退休阶段，社交网络明显缩小，再加上收入减少、行动能力下降以及同代人相继死亡等因素，其社交活动受到明显影响；但适度饮酒可以促进社会联系，增强人际关系和社会互动，提高社交活跃度，有助于形成和加强社会支持系统，对个人的身心健康产生一定的积极影响，导致社交活跃度与衰弱发生风险之间的关联更为密切[19]。
3.2.3　生活满意度
生活满意度亚组分析发现，社交活跃度对高生活满意度老年人的衰弱发生风险有影响，在生活满意度低的人群中这种影响不明显。社会资本理论把社会联系看作是一种与自身生存直接相关的生理需要，当社会联系减弱时，人会出现一种生物适应性反应，促使人们重新与社会建立联系[20]。对于生活满意度高的老年人来说，社交活跃度处于低水平是一种不良的生活状态，身体会对这种不良状态做出反应，试图摆脱并积极参与到社会互动中，从而延缓衰弱的发生。而生活满意度低的人群常表现出负性情绪，导致低水平的社交活跃度对衰弱的影响并不明显[21]。
4　小结
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本研究从社会参与的角度出发，通过队列研究验证了社交活跃度与衰弱发生的相关性，提示医务人员应对男性、现在饮酒以及生活满意度高的老年人在心理、社会等方面的变化予以重视，为其构建良好的社交网络，必要时进行心理干预。
此外，有研究表明，社会支持、经济水平、主观健康状况、行动能力等是影响老年人社交活动的重要因素[22]，未来对社交活跃度相关的干预研究可从其影响因素出发，根据不同特征人群制定有效的个性化干预方案，从而构建良好的社交网络，延缓衰弱的发生。
但本研究也存在一定局限性，如社交活动数据及衰弱评估指标均由受试者回忆填写，可能存在一定的回忆偏倚，可能对结果的准确性产生影响；研究中虽然考虑了部分混杂因素，但未对饮食、体力活动水平等因素进行测量，可能造成残余混杂；研究失访人数较多，可能造成失访偏倚，低估或高估社交活跃度对衰弱发生的影响。

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doi: 10.12102/j.issn.1009-6493.2026.01.011
  • 接收时间：2025-03-29
  • 首发时间：2026-10-28
  • 出版时间：2026-01-10
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  • 收稿日期：2025-03-29
  • 修回日期：2025-11-18
基金
作者信息
    1常州大学医学与健康工程学院，江苏 213000

通讯作者:

张琳琳，E-mail：
ZHANG Linlin, E-mail:
参考文献
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https://castjournals.cast.org.cn/joweb/hlyj/CN/10.12102/j.issn.1009-6493.2026.01.011
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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