马来西亚老年人不良社会经济地位的相关因素：根据城乡环境的分析。
Factors associated with poor socioeconomic status among Malaysian older adults: an analysis according to urban and rural settings.
机构信息
Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
Nutrition and Dietetics Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
出版信息
BMC Public Health. 2019 Jun 13;19(Suppl 4):549. doi: 10.1186/s12889-019-6866-2.
BACKGROUND
Poverty at old age is associated with poor dietary habit, nutritional status and higher rates of chronic diseases and psychosocial problems. However, there is limited information about this matter according to urban and rural settings. The aim of this study was to identify dietary, nutritional, physical and cognitive factors associated with poor socioeconomic status (SES) among older adults according to urban and rural settings in Malaysia.
METHODS
An analysis was conducted among 2237 older adults who participated in a longitudinal study on aging (LRGS TUA). This study involved four states in Malaysia, with 49.4% from urban areas. Respondents were divided into three categories of SES based on percentile, stratified according to urban and rural settings. SES was measured using household income.
RESULTS
The prevalence of low SES was higher among older adults in the rural area (50.6%) as compared to the urban area (49.4%). Factors associated with low SES among older adults in an urban setting were low dietary fibre intake (Adj OR:0.91),longer time for the Timed up and Go Test (Adj OR:1.09), greater disability (Adj OR:1.02), less frequent practice of caloric restriction (Adj OR:1.65), lower cognitive processing speed score (Adj OR:0.94) and lower protein intake (Adj OR:0.94). Whilst, among respondents from rural area, the factors associated with low SES were lack of dietary fibre intake (Adj OR:0.79), lower calf circumference (Adj OR: 0.91), lesser fresh fruits intake (Adj OR:0.91), greater disability (Adj OR:1.02) and having lower score in instrumental activities of daily living (Adj OR: 0.92).
CONCLUSION
Lower SES ismore prevalent in rural areas. Poor dietary intake, lower fitness and disability were common factors associated with low in SES, regardless of settings. Factors associated with low SES identifiedin both the urban and rural areas in our study may be useful inplanning strategies to combat low SES and its related problems among older adults.
背景
老年人贫困与不良饮食习惯、营养状况以及更高的慢性病和心理社会问题发生率有关。然而，根据城乡环境，关于这方面的信息有限。本研究旨在根据马来西亚城乡环境，确定与老年人较差社会经济地位（SES）相关的饮食、营养、身体和认知因素。
方法
对参加老龄化纵向研究（LRGS TUA）的 2237 名老年人进行了一项分析。这项研究涉及马来西亚的四个州，其中 49.4%来自城市地区。根据百分位数将受访者分为 SES 三个类别，并根据城乡环境分层。SES 是通过家庭收入来衡量的。
结果
农村地区老年人 SES 较低的比例（50.6%）高于城市地区（49.4%）。城市地区 SES 较低的老年人相关因素为膳食纤维摄入量低（调整后的比值比（OR）：0.91）、“计时站起行走测试”时间更长（调整后的 OR：1.09）、残疾程度更高（调整后的 OR：1.02）、热量限制实践频率较低（调整后的 OR：1.65）、认知处理速度评分较低（调整后的 OR：0.94）和蛋白质摄入量较低（调整后的 OR：0.94）。而在农村地区，与 SES 较低相关的因素为膳食纤维摄入量低（调整后的 OR：0.79）、小腿围度小（调整后的 OR：0.91）、新鲜水果摄入量少（调整后的 OR：0.91）、残疾程度更高（调整后的 OR：1.02）以及日常生活活动工具性评分较低（调整后的 OR：0.92）。
结论
农村地区 SES 较低的比例更高。无论环境如何，较差的饮食摄入、较低的健康水平和残疾是与 SES 较低相关的常见因素。我们在城乡地区确定的与 SES 较低相关的因素，可能有助于制定策略来解决老年人 SES 及其相关问题。
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