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Article(id=1241322675411406911, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202209123, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1663084800000, receivedDateStr=2022-09-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883988478, onlineDateStr=2026-03-19, pubDate=1706112000000, pubDateStr=2024-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883988478, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883988478, creator=13701087609, updateTime=1773883988478, updator=13701087609, issue=Issue{id=1241322661654098823, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883985198, creator=13701087609, updateTime=1773890256678, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241348966214849502, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241348966214849503, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241322661654098823, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=205, endPage=209, ext={EN=ArticleExt(id=1241322675763728472, articleId=1241322675411406911, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Childhood disabilities among middle-aged and elderly people in China and the impact on their long-term health, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To know the status of childhood disabilities among middle-aged and old people in China and its influence, and to provide basis for prevention and rehabilitation of childhood disability.

Methods

The data were from the China Health and Retirement Longitudinal Study. The middle-aged and old people who participated in the baseline survey in 2011 and the newly visited middle-aged and old people who were included in the follow-up in 2013, 2015 and 2018 were selected as the research objects. The disability rate during their childhood was described, and the difference of education level, marriage, daily living ability between disability during childhood and adult were analysed.

Results

Among the middle-aged and old people in China, the childhood disability rate was 20.36‰, and the rates of physical disability, intellectual disability, visual disability, hearing disability and speech disability were 8.47‰, 4.36‰, 3.57‰, 5.58‰, and 2.01‰, respectively. The number of childhood disabilities accounted for 12.2% of the total number of disabled people in the middle-aged and elderly. Among the people with disabilities in the childhood period, the proportion of males was higher than females, accounting for 54.1%. Most of the disabled people in the childhood period are from 0 to 6 years old, accounting for 58.2% of the disabled people from 0 to 17 years old. Compared with those with disabilities during childhood, those with disabilities in adulthood, with physical, intellectual, hearing, and speech disabilities had a higher proportion of impaired ADL in middle and old age. Those with visual, hearing, and speech disabilities in adulthood had a higher proportion of depressive symptoms in middle and old age. The differences were statistically significant by χ2 test(P<0.05).

Conclusion

About 2% of the middle-aged and elderly people in China suffer from disability during their childhood. The impact of childhood disability runs through the whole life cycle. It is of great significance to take active prevention and rehabilitation measures for the childhood disabilities.

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目的

了解我国中老年人群中儿童期患残疾情况及由此带来的影响，为儿童期残疾的预防及康复提供依据。

方法

数据来自中国健康与养老追踪调查（简称CHARLS），选取了参与2011年基线调查的中老年人以及2013年、2015年、2018年随访中纳入新访问的中老年人作为研究对象，描述其儿童期患残疾率，分析儿童期、成年后患残疾对于日常生活活动能力、心理健康等远期影响的差别。

结果

我国中老年人群中，儿童期患残疾率为20.36‰，其中患肢体残疾、智力残疾、视力残疾、听力残疾、言语残疾的率分别为8.47‰、4.36‰、3.57‰、5.58‰、2.01‰。儿童期患残人数占中老年人总体患残人数的12.2%。儿童期患残疾人群中，男性所占比例较女性高，为54.1%；多重残疾中，听力残疾合并语言残疾者较多，占多重残疾的43.4%；儿童期患残疾年龄多集中在0~6岁阶段，占0~17岁患残疾人数的58.2%。与儿童期患残疾的人群相比，成年后患残疾，患有肢体残疾、智力残疾、听力残疾、言语残疾的人群，中老年期ADL受损的比例更高；成年后患视力残疾、听力残疾、言语残疾的人群，中老年期出现抑郁症状的比例更高；均P<0.05。

结论

我国约2%的中老年人在儿童期患有残疾，由儿童期患残所带来的影响贯穿全生命周期，对儿童期残疾采取积极的预防及康复措施对其远期的健康有积极的改善意义。

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王琳琳，E-mail：
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杨胜慧（1990－），女，硕士在读，主管医师，研究方向：健康教育、流行病与卫生统计

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Journal of Intellectual Disability Research, 2017, 61(1): 62-74., articleTitle=Mortality inpeople with intellectual disabilities in England, refAbstract=null)], funds=[Fund(id=1241322683019874761, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, awardId=21&ZD187, language=CN, fundingSource=国家社科基金重大项目(21&ZD187), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241322677802160263, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, xref=1., ext=[AuthorCompanyExt(id=1241322677814743178, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, companyId=1241322677802160263, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute of Reproductive Health of Public Health School of Peking University, Key Laboratory of Reproductive Health, National Health Commission, Beijing 100191, China), AuthorCompanyExt(id=1241322677827326091, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, companyId=1241322677802160263, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.北京大学公共卫生学院生育健康研究所/国家卫生健康委生育健康重点实验室，北京 100191)]), AuthorCompany(id=1241322677923795092, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, xref=2., ext=[AuthorCompanyExt(id=1241322677927989398, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, companyId=1241322677923795092, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.天津市卫生健康促进中心)])], figs=[ArticleFig(id=1241322680184525153, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=EN, label=Table 1, caption=

Disability among the middle-aged and elderly population

, figureFileSmall=null, figureFileBig=null, tableContent=
残疾类型儿童期患残疾成年后患残疾总体患残疾情况
患病人数患病率（‰）患病人数患病率（‰）患病人数患病率（‰）
残疾a41620.362 992146.463 408166.82
肢体残疾1738.4768133.3385441.80
智力残疾894.3648523.7457428.10
视力残疾733.571 10754.191 18057.76
听力残疾1145.581 52974.841 64380.42
言语残疾412.01653.181065.19
), ArticleFig(id=1241322681719640425, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=CN, label=表1, caption=

中老年人群患残疾情况

, figureFileSmall=null, figureFileBig=null, tableContent=
残疾类型儿童期患残疾成年后患残疾总体患残疾情况
患病人数患病率（‰）患病人数患病率（‰）患病人数患病率（‰）
残疾a41620.362 992146.463 408166.82
肢体残疾1738.4768133.3385441.80
智力残疾894.3648523.7457428.10
视力残疾733.571 10754.191 18057.76
听力残疾1145.581 52974.841 64380.42
言语残疾412.01653.181065.19
), ArticleFig(id=1241322681837080948, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=EN, label=Table 2, caption=

Basic information on childhood disabilities

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总体男女χ2值P值
患病人数构成比
（%）		患病人数构成比
（%）		患病人数构成比
（%）
残疾类型3.2560.661
肢体残疾14033.77533.36534.0
智力残疾7016.83515.63518.3
视力残疾6114.73917.32211.5
听力残疾7919.04017.83920.4
言语残疾133.173.163.1
多重残疾5312.72912.92412.6
患残疾年龄（岁）0.3900.823
0~624258.212856.911459.7
7~1210926.26026.74925.7
13~176515.63716.42814.6
婚姻状况2.1620.141
在婚33179.617376.915882.7
不在婚8520.45223.13317.3
受教育水平31.167<0.001
小学以下23556.59944.013671.2
小学8520.46026.72513.1
初中及以上9623.16629.33015.7
16岁前居住地0.6580.417
城镇36190.919692.016589.7
农村369.1178.01910.3
), ArticleFig(id=1241322682055184774, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=CN, label=表2, caption=

儿童期残疾的基本情况

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总体男女χ2值P值
患病人数构成比
（%）		患病人数构成比
（%）		患病人数构成比
（%）
残疾类型3.2560.661
肢体残疾14033.77533.36534.0
智力残疾7016.83515.63518.3
视力残疾6114.73917.32211.5
听力残疾7919.04017.83920.4
言语残疾133.173.163.1
多重残疾5312.72912.92412.6
患残疾年龄（岁）0.3900.823
0~624258.212856.911459.7
7~1210926.26026.74925.7
13~176515.63716.42814.6
婚姻状况2.1620.141
在婚33179.617376.915882.7
不在婚8520.45223.13317.3
受教育水平31.167<0.001
小学以下23556.59944.013671.2
小学8520.46026.72513.1
初中及以上9623.16629.33015.7
16岁前居住地0.6580.417
城镇36190.919692.016589.7
农村369.1178.01910.3
), ArticleFig(id=1241322682445255065, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=EN, label=Table 3, caption=

Differences in ADL impairment between childhood and adulthood with disabilities among middle-aged and elderly individuals

, figureFileSmall=null, figureFileBig=null, tableContent=
残疾类型儿童期患残疾成年后患残疾χ2值P值
ADL受损ADL正常ADL受损ADL正常
残疾113(27.2)303(72.8)1 089(36.4)1 903(63.6)13.639<0.001
肢体残疾55(31.8)118(68.2)353(51.8)328(48.2)22.213<0.001
智力残疾27(30.3)62(69.7)212(43.7)273(56.3)5.5350.019
视力残疾20(27.4)53(72.6)400(36.1)707(63.9)2.2800.131
听力残疾25(21.9)89(78.1)542(35.4)987(64.6)8.5780.003
言语残疾10(24.4)31(75.6)51(78.5)14(21.5)30.088<0.001
), ArticleFig(id=1241322682554306978, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=CN, label=表3, caption=

儿童期、成年后患残疾中老年期ADL受损情况的区别

, figureFileSmall=null, figureFileBig=null, tableContent=
残疾类型儿童期患残疾成年后患残疾χ2值P值
ADL受损ADL正常ADL受损ADL正常
残疾113(27.2)303(72.8)1 089(36.4)1 903(63.6)13.639<0.001
肢体残疾55(31.8)118(68.2)353(51.8)328(48.2)22.213<0.001
智力残疾27(30.3)62(69.7)212(43.7)273(56.3)5.5350.019
视力残疾20(27.4)53(72.6)400(36.1)707(63.9)2.2800.131
听力残疾25(21.9)89(78.1)542(35.4)987(64.6)8.5780.003
言语残疾10(24.4)31(75.6)51(78.5)14(21.5)30.088<0.001
), ArticleFig(id=1241322682688524716, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=EN, label=Table 4, caption=

Differences in depressive symptoms between childhood and adulthood with disabilities among middle-aged and elderly individuals

, figureFileSmall=null, figureFileBig=null, tableContent=
残疾类型儿童期患残疾成年后患残疾χ2值P值
抑郁症状无抑郁症状抑郁症状无抑郁症状
残疾152（46.9）172（53.1）1 225（52.1）1 124（47.9）3.1260.077
肢体残疾67（47.9）73（52.1）284（54.9）233（45.1）2.2160.137
智力残疾38(63.6)22(36.7)197(59.9）132（40.1）0.2530.615
视力残疾25(41.0)36(59.0)531(57.0)401(43.0)5.9410.015
听力残疾27(38.0)44(62.0)623(53.2)549(46.8)6.1420.013
言语残疾6(42.9)8(57.1)20(76.9)6(23.1)4.6420.031
), ArticleFig(id=1241322682860491196, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241322675411406911, language=CN, label=表4, caption=

儿童期、成年后患残疾中老年期出现抑郁症状的区别

, figureFileSmall=null, figureFileBig=null, tableContent=
残疾类型儿童期患残疾成年后患残疾χ2值P值
抑郁症状无抑郁症状抑郁症状无抑郁症状
残疾152（46.9）172（53.1）1 225（52.1）1 124（47.9）3.1260.077
肢体残疾67（47.9）73（52.1）284（54.9）233（45.1）2.2160.137
智力残疾38(63.6)22(36.7)197(59.9）132（40.1）0.2530.615
视力残疾25(41.0)36(59.0)531(57.0)401(43.0)5.9410.015
听力残疾27(38.0)44(62.0)623(53.2)549(46.8)6.1420.013
言语残疾6(42.9)8(57.1)20(76.9)6(23.1)4.6420.031
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我国中老年人儿童期患残疾情况及对其远期健康的影响分析
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杨胜慧 1, 2 , 杨晨 1 , 袁珍 1 , 王琳琳 1
现代预防医学 | 流行病与统计方法 2024,51(2): 205-209
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现代预防医学 | 流行病与统计方法 2024, 51(2): 205-209
我国中老年人儿童期患残疾情况及对其远期健康的影响分析
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杨胜慧1, 2, 杨晨1, 袁珍1, 王琳琳1
作者信息
  • 1.北京大学公共卫生学院生育健康研究所/国家卫生健康委生育健康重点实验室，北京 100191
  • 2.天津市卫生健康促进中心

    • 杨胜慧（1990－），女，硕士在读，主管医师，研究方向：健康教育、流行病与卫生统计

通讯作者:

王琳琳，E-mail：
Childhood disabilities among middle-aged and elderly people in China and the impact on their long-term health
Sheng-hui YANG1, 2, Chen YANG1, Zhen YUAN1, Lin-lin WANG1
Affiliations
  • Institute of Reproductive Health of Public Health School of Peking University, Key Laboratory of Reproductive Health, National Health Commission, Beijing 100191, China
出版时间: 2024-01-25 doi: 10.20043/j.cnki.MPM.202209123
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摘要
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目的

了解我国中老年人群中儿童期患残疾情况及由此带来的影响，为儿童期残疾的预防及康复提供依据。

方法

数据来自中国健康与养老追踪调查（简称CHARLS），选取了参与2011年基线调查的中老年人以及2013年、2015年、2018年随访中纳入新访问的中老年人作为研究对象，描述其儿童期患残疾率，分析儿童期、成年后患残疾对于日常生活活动能力、心理健康等远期影响的差别。

结果

我国中老年人群中，儿童期患残疾率为20.36‰，其中患肢体残疾、智力残疾、视力残疾、听力残疾、言语残疾的率分别为8.47‰、4.36‰、3.57‰、5.58‰、2.01‰。儿童期患残人数占中老年人总体患残人数的12.2%。儿童期患残疾人群中，男性所占比例较女性高，为54.1%；多重残疾中，听力残疾合并语言残疾者较多，占多重残疾的43.4%；儿童期患残疾年龄多集中在0~6岁阶段，占0~17岁患残疾人数的58.2%。与儿童期患残疾的人群相比，成年后患残疾，患有肢体残疾、智力残疾、听力残疾、言语残疾的人群，中老年期ADL受损的比例更高；成年后患视力残疾、听力残疾、言语残疾的人群，中老年期出现抑郁症状的比例更高；均P<0.05。

结论

我国约2%的中老年人在儿童期患有残疾，由儿童期患残所带来的影响贯穿全生命周期，对儿童期残疾采取积极的预防及康复措施对其远期的健康有积极的改善意义。

儿童期残疾  /  中老年人群  /  影响
Objective

To know the status of childhood disabilities among middle-aged and old people in China and its influence, and to provide basis for prevention and rehabilitation of childhood disability.

Methods

The data were from the China Health and Retirement Longitudinal Study. The middle-aged and old people who participated in the baseline survey in 2011 and the newly visited middle-aged and old people who were included in the follow-up in 2013, 2015 and 2018 were selected as the research objects. The disability rate during their childhood was described, and the difference of education level, marriage, daily living ability between disability during childhood and adult were analysed.

Results

Among the middle-aged and old people in China, the childhood disability rate was 20.36‰, and the rates of physical disability, intellectual disability, visual disability, hearing disability and speech disability were 8.47‰, 4.36‰, 3.57‰, 5.58‰, and 2.01‰, respectively. The number of childhood disabilities accounted for 12.2% of the total number of disabled people in the middle-aged and elderly. Among the people with disabilities in the childhood period, the proportion of males was higher than females, accounting for 54.1%. Most of the disabled people in the childhood period are from 0 to 6 years old, accounting for 58.2% of the disabled people from 0 to 17 years old. Compared with those with disabilities during childhood, those with disabilities in adulthood, with physical, intellectual, hearing, and speech disabilities had a higher proportion of impaired ADL in middle and old age. Those with visual, hearing, and speech disabilities in adulthood had a higher proportion of depressive symptoms in middle and old age. The differences were statistically significant by χ2 test(P<0.05).

Conclusion

About 2% of the middle-aged and elderly people in China suffer from disability during their childhood. The impact of childhood disability runs through the whole life cycle. It is of great significance to take active prevention and rehabilitation measures for the childhood disabilities.

Childhood disability  /  Middle aged and old people  /  Influence
杨胜慧, 杨晨, 袁珍, 王琳琳. 我国中老年人儿童期患残疾情况及对其远期健康的影响分析. 现代预防医学, 2024 , 51 (2) : 205 -209 . DOI: 10.20043/j.cnki.MPM.202209123
Sheng-hui YANG, Chen YANG, Zhen YUAN, Lin-lin WANG. Childhood disabilities among middle-aged and elderly people in China and the impact on their long-term health[J]. Modern Preventive Medicine, 2024 , 51 (2) : 205 -209 . DOI: 10.20043/j.cnki.MPM.202209123
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随着我国老龄化进程的不断加快及社会医疗环境的进一步改善，老年残疾人的比例在不断提高，我国的残疾人问题正在凸显为老年残疾人问题[1-2]。残疾儿童的存活时间延长，儿童期患残疾将带来全生命周期的影响，因此该群体在老龄化背景下更需要被关注。目前我国针对儿童残疾的研究主要依据1987年与2006年进行的两次全国残疾人抽样调查数据[3-5]，大多限于儿童残疾患病率的报道，缺乏儿童期患残与成年期患残在构成比、及对远期健康影响的差异研究。本文利用中国健康与养老追踪调查数据估计我国儿童期残疾的情况，客观评价人口老龄化背景下儿童期残疾对于远期健康所带来的影响，为儿童期残疾的预防及康复提供依据。
1　资料与方法
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1.1　资料来源
本研究所用数据来自“中国健康与养老追踪调查”（China Health and Retirement Longitudinal Study, 简称CHARLS），CHARLS是由北京大学国家发展研究院主持的一项针对中国45岁及以上中老年人进行的大规模抽样调查，所收集信息广泛涉及社会经济状况、个人健康状况、健康行为等多个方面。在基线调查中，CHARLS在全国28个省150个区县的450个村居展开，具体调查对象为目标家庭中随机的一名45岁及以上的中老年人。CHARLS基线调查成功访问了17 708人，总体上可以代表全国中老年人群。本研究选取了参与2011年基线调查的中老年人以及2013年、2015年、2018年随访中纳入的新访问的中老年人作为研究对象，剔除重要变量缺失及存在逻辑错误的样本后，最终纳入本研究的45岁及以上的中老年人为20 429人。
1.2　残疾分类
CHARLS调查问卷将残疾分为肢体残疾、智力残疾、视力残疾、智力残疾、言语残疾5类，基本遵循《残疾人残疾分类和分级》国家标准(GB/T26341-2010)，但未涉及精神残疾。本研究将发生在0~17岁的残疾定义为儿童期残疾，文章中残疾即患一种及以上类型残疾，多重残疾即患两种或两种以上残疾。
1.3　指标定义
本研究为评估儿童期残疾对于远期健康所带来的影响，选取日常生活活动能力（Activities of Daily Living，简称ADL）、抑郁症状这两个关键指标进行分析。ADL采用躯体生活自理量表（Basic Activities of Daily Living, BADL）测定[6]，该量表包括洗澡、进食、上下床、穿衣、如厕、控制排便等6个项目，每个项目分为“完成没有困难”、“有困难但仍可以完成”、“有困难需要帮助”、“无法完成”4个程度，量表中6项均完成没有困难为自理，即ADL正常，有≥1项需要他人帮助或无法完成为ADL受损。抑郁评估采取抑郁量表CES-D10条目简易量表，包括：(1)我因一些小事而烦恼；(2)我在做事时很难集中注意力；(3)我感到情绪低落；(4)我觉得做任何事都很费劲；(5)我对未来充满希望；(6)我感到害怕；(7)我的睡眠不好；(8)我很愉快；(9)我感到孤独；(10)我觉得我无法继续我的生活。各条目下的选项分为4个等级：很少或根本没有(<1 d)；不太多(1～2 d)；有时候或者说有一半时间(3～4 d)；大多数时间(5～7 d)。根据标准计算抑郁得分，4个等级得分依次为0、1、2、3分，其中第5条目和第8条目反向计分，10条目总分在0～30分之间，10分及以上的认为有抑郁症状[7]。
1.4　统计分析
利用SPSS 26.0软件进行统计分析，采用描述性统计方法描述调查对象的基本特征，采用χ2 检验进行儿童期与成年后患残疾对于ADL、抑郁症状影响的单因素分析，检验水准α=0.05。
2　结果
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2.1　基本情况
2.1.1　中老年人群患残疾情况
本次研究共纳入调查对象20 429人，3 408人患有残疾，患残疾率为166.82‰。其中儿童期患残疾人数为416人，成年后患残疾人数为2 992人。儿童期患残率为20.36‰，其中患有肢体残疾率最高，为8.47‰；患言语残疾的率最低，为2.01‰。儿童期患残人数占中老年人总体患残人数的12.2%（416/3 408）。儿童期患残疾人群中，男性225人，占54.1%，女性191人，占45.9%。在儿童期，363人患单一残疾，53人患多重残疾，其中听力残疾合并语言残疾者有23人，占患多重残疾人数的43.4%。具体情况见表1。
2.1.2　儿童期患残疾的基本情况
本次调查的中老年人儿童期患残疾人群中，男女患残疾类型、患残疾年龄、婚姻状况、童年居住地属性差异无统计学意义（P>0.05），儿童期女性患残疾者较男性患残疾者受教育水平为小学以下的比例更大、初中及以上的比例更少，经χ2 检验，差异具有统计学意义（P<0.05）。此外，儿童期患残疾年龄多集中在0~6岁阶段，占58.2%（242/416），具体情况见表2。
2.2　儿童期残疾对远期健康造成的影响
2.2.1　不同时期患残疾与中老年期ADL的关系
总人群ADL受损率为16.1%（3 280/20 429），残疾人群ADL受损率为35.3%（1 202/3 408）。与儿童期患残疾的人群相比，成年后患残疾，患有肢体残疾、智力残疾、听力残疾、言语残疾的人群，中老年期ADL受损的比例更高，经χ2 检验，差异具有统计学意义（P<0.05）。5种残疾类型中，成年后患有言语残疾的人群ADL受损率最高，为78.5%。具体情况见表3。
2.2.2　不同时期患残疾与中老年期发生抑郁症状的关系
总人群抑郁症状检出率为34.7%（6 011/17 311），残疾人群抑郁症状检出率为51.5%（1 377/2 673）。与儿童期患残疾的人群相比，成年后患视力残疾、听力残疾、言语残疾的人群，中老年期出现抑郁症状的比例更高，经χ2 检验，差异具有统计学意义（P<0.05）。具体情况见表4。
3　讨论
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随着我国老龄化程度的进一步加剧，“老年带残”问题日益凸显，2006年我国残疾总人口达8 296万，其中60岁以上老年残疾人为4 416万，占比超过50%[1]，而儿童期患残疾存活至老年阶段是“老年带残”的重要途径。本研究将0~17岁患残疾定义为儿童期残疾，利用CHARLS数据评估中老年人群中儿童期患残疾的情况以及对远期健康所带来的影响。
本研究结果显示，中老年人群中儿童期残疾率为20.36‰，患肢体残疾、智力残疾、视力残疾、听力残疾、言语残疾的率分别为8.47‰、4.36‰、3.57‰、5.58‰、2.01‰。本研究第一次描述了中老年人群儿童期残疾的患病率，由于我国人口基数大，儿童期患残疾存活至中老年阶段的人数较多，且儿童期患残疾多发生于0~6岁阶段，因此该群体患残疾所带来的影响贯穿全生命周期，早期采取干预措施对其健康有积极意义。
我国中老年残疾人的健康状况不容乐观[8]，ADL受损及抑郁情况都比较突出[9-10]，ADL受损严重影响中老年人的生活独立性及生活质量，此外ADL受损也被证明与中老年人的焦虑及抑郁症状显著相关[9-11]，也会显著增加中老年人发生死亡的风险[12] ；本研究表明，儿童期患残疾的人群，其中老年期ADL受损率、抑郁症状检出率显著低于成年后患残疾的人群，这可能由于残疾儿童正处于康复的黄金时间，通过早发现、早诊断、早干预，功能能够得到显著改善，健康状况存在一定程度的转归[13-14]，因此对于中老年期的生活功能影响远小于成年后患残疾所带来的较为近期的影响，也进一步证实了针对儿童期残疾开展康复治疗对于改善其日后的健康状况具有积极的意义。
本研究不足之处在于使用CHARLS数据分析儿童期患残疾率及由此所带来的影响，由于调查人群均存活至45岁及以上，根据以往文献报道残疾人群的死亡风险比健全人群要高，预期寿命要低[15-17]，因此很可能会低估了儿童期残疾率及所带来的影响。
基金
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  • 国家社科基金重大项目(21&ZD187)
文献
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2024年第51卷第2期
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文章信息
doi: 10.20043/j.cnki.MPM.202209123
  • 接收时间：2022-09-14
  • 首发时间：2026-03-19
  • 出版时间：2024-01-25
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  • 收稿日期：2022-09-14
基金
国家社科基金重大项目(21&ZD187)
作者信息
    1.北京大学公共卫生学院生育健康研究所/国家卫生健康委生育健康重点实验室，北京 100191
    2.天津市卫生健康促进中心

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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