【摘要】 目的 调查我国西部地区农村老年人生活自理能力的现状及影响因素，为提高老年人日常生活活动能力与健康服务提供依据参考。方法 采用多阶段随机整群抽样方法，对我国西部地区4省(直辖市)8个县的3579名65岁及以上农村老年人进行生活自理能力(activities of daily living, ADL)问卷调查，并通过多因素Logistic回归模型分析影响自理能力水平的因素。结果 此次研究对象共3573人，可自理人数3381人(94.63%)、依赖人数192人(5.37%),其中轻度依赖、中度依赖、不能自理分别占44.27%、26.04%、29.69%。多因素Logistic回归分析显示，以65～74岁年龄段为参照，75～84岁年龄段OR值为2.705(95%CI:1.840-3.977),85岁～年龄段为3.337(95%CI:1.881～5.917);以家务为参照，牧民OR值为4.738(95%CI:2.306～9.736);以已婚为参照，分居或离婚OR值为9.553(95%CI:3.056～29.866);以不患慢性病为参照，患3种及以上慢性病OR值为3.778(95%CI:1.659～8.606);以无跌倒为参照，跌倒OR值为2.382(95%CI:1.514～3.747);以听力正常为参照，听力严重退化OR值为3.707(95%CI:2.087～6.585)是老年人生活不能自理的独立危险因素；居住方式为丧偶独居OR为0.363(95%CI:0.169～0.781)和参加锻炼OR为0.308(95%CI:0.209～0.456)是保护因素。结论 我国西部地区农村老年人生活自理能力现状不容乐观、影响因素较多，要对生活能力有依赖程度的老人提供合理的健康服务，如康复护理指导、健康教育及配备合适的辅助设施等，以预防或延缓老年人失能的发展进程。更多还原

【Abstract】 Objective To examine the status of activities of daily living and its influence factors among the rural elderly in western China and provide the basis for improving the elder people′s ability of daily life activity and health services. Methods A questionnaire survey of activities of daily living(ADL)was conducted among 3579 rural elderly aged 65 and above in 8 counties of 4 provinces(municipalities)in western China by multi-stage random cluster sampling, and the factors influencing the level of self-care were analyzed by multivariate logistic regression model. Results Among 3579 elderly persons, of whom 3381(94.63%)were able to take care of themselves and 192(5.37%)were dependent, of which 44.27% were lightly dependent, 26.04% were moderately dependent and 29.69% were unable to take care of themselves.Multivariate logistic regression analysis showed that, compared with the age group of 65-74,the OR value of 75-84 was 2.705(95%CI:1.840-3.977),and that of 85-was 3.337(95%CI:1.881-5.917). Taking housework as a reference, the OR value of herdsmen was 4.738(95%CI:2.306-9.736). Taking married as a reference, the OR value of separation or divorce was 9.553(95%CI:3.056-29.866). Taking no chronic diseases as a reference, the OR value of suffering from three or more chronic diseases was 3.778(95%CI:1.659-8.606). Taking no falls as a reference, the OR value of falls was 2.382(95%CI:1.514-3.747);taking normal hearing as a reference, the OR value of severe hearing deterioration of 3.707(95%CI:2.087-6.585). Living style of widowed and living alone(OR=0.363,95%CI:0.169-0.781)and participating in exercise(OR=0.308,95%CI:0.209-0.456)were the protective factors. Conclusion The status of self-care ability of rural elderly in western China is not optimistic, and there are many influencing factors.It is necessary to provide reasonable health services, such as rehabilitation nursing guidance, health education and appropriate auxiliary facilities, to prevent or delay the development of disability of the elderly.更多还原