【摘要】 目的 了解我国独居老年人慢性病共病现状和特征，分析其共病模式，探索健康相关行为与独居老年人慢性病共病的关联，旨在为老年人多病共防和共管提供依据。方法 采用2018年中国老年健康影响因素跟踪调查(Chinese longitudinal healthy longevity survey,CLHLS)数据，使用网络图识别独居老年人慢性病共病中常见的二元共病模式，并运用Gephi软件对老年人慢性病共病网络进行可视化；运用Apriori算法，通过关联规则分析健康相关行为与独居老年人共病情况的关联性，使用多因素logistic回归模型分析独居老年人慢性病共病与健康相关行为的关联大小。结果 共纳入1 905名65岁以上的独居老年人，其中766人患有两种及以上慢性疾病，慢性病共病率为40.2%。通过网络图分析共发现45种有意义的具有中强链接的二元共病模式，其中10种与高血压有关，7种与心脏病有关。独居老年人健康相关行为与共病情况的关联规则中的强关联规则为睡眠质量差、无体力活动、无锻炼、无户外活动；多因素logistic回归模型显示：与无慢性病共病的独居老年人相比，会吸烟（OR=1.791,95%CI:1.205～2.664）与饮酒（OR=1.597,95%CI:1.084～2.353）的独居老年人慢性病共病风险增加；有锻炼（OR=0.132,95%CI:0.100～0.175）、有户外活动（OR=0.047,95%CI:0.035～0.063）、睡眠质量好（OR=0.469,95%CI:0.319～0.688）、睡眠充足（OR=0.648,95%CI:0.484～0.867）健康促进行为的独居老年人慢性病共病风险降低。结论 我国独居老年人的共病模式复杂，且与健康相关行为存在关联，可通过改善健康相关行为、比如增加锻炼和户外活动以及调整睡眠时长和睡眠质量等针对性干预措施降低老年人的共病风险。更多还原

【Abstract】 Objective To understand the current situation and characteristics of chronic disease comorbidities among the elderly living alone in China, to analyze their comorbidity patterns, and to explore the relationship between health-related behaviors and chronic comorbidity in the elderly living alone, so as to provide basis for co-prevention and co-management of multiple diseases in the elderly. Methods Based on the data of the 2018 Chinese longitudinal healthy longevity survey(CLHLS), the network map was used to identify the common binary co-disease patterns of chronic diseases in the elderly living alone, and the Gephi software was used to visualize the chronic disease co-disease network of the elderly. Using Apriorism algorithm, the association rules were used to analyze the correlation between health-related behaviors and co-diseases of the elderly living alone, and multi-factor Logistic regression model was used to analyze the correlation between chronic diseases and health-re-lated behaviors of the elderly living alone. Results A total of 1 905 elderly people living alone over 65 years were included, of whom 766 suffered from two or more chronic diseases, and the co-morbidity of chronic diseases was 40.2%. A total of 45meaningful binary co-disease patterns with strong links were identified through network map analysis, of which 10 were related to hypertension and 7 were related to heart disease. The strong association rules among the association rules of health-related behaviors and co-diseases of the elderly living alone were poor sleep quality, no physical activity, no exercise, and no outdoor activity. The multivariate Logistic regression model showed that the elderly living alone with smoking(OR =1.791, 95% CI:1.205-2.664) and alcohol consumption(OR=1.597, 95%CI: 1.084-2.353) had an increased risk of chronic co-disease compared with those without chronic diseases. Elderly people living alone with exercise(OR=0.132, 95%CI: 0.100-0.175), outdoor activities(OR=0.047, 95%CI: 0.035-0.063), good sleep quality(OR=0.469, 95%CI: 0.319-0.688), and adequate sleep(OR=0.648,95%CI: 0.484-0.867) had a lower risk of chronic comorbidity. Conclusion The comorbidity pattern of the elderly living alone in China is complex and related to health-related behaviors. The risk of comorbidity in the elderly can be reduced by improving health-related behaviors, such as increasing exercise and outdoor activities and adjusting sleep duration and sleep quality.更多还原