Development trajectories and influencing factors of self-neglect behavior in older adults
Objective To identify the development trajectories of self-neglect behavior in older a-dults and explore the associated influencing factors.Methods A fixed cohort was constructed based on the data from three surveys of Chinese longitudinal healthy longevity survey(CLHLS)from 2011 to 2018.A to-tal of eight variables from 4 dimensions including living environment,lifestyle,social interaction,and health care were selected to evaluate self-neglect.Group-based trajectory model was used to identify the develop-ment trajectory of self-neglect behavior in the older adults,and polynomial Logistic regression model was used to explore its influencing factors by Stata 16.1.Results Finally,2 754 older adults aged 60 and above were included.The development trajectory of self-neglect behavior in older adults,based on the group-based trajec-tory model,can be classified into stable-low group(n=268,9.7％),descending-moderate group(n=2 224,80.8％),and decreasing-high group(n=262,9.5％).Polynomial Logistic regression showed that,compared with stable-low group,living in rural areas(B=1.116,OR=3.053,95％CI=2.278-4.091)and higher ac-tivities of daily living scores(B=0.137,OR=1.147,95％CI=1.046-1.258)were the risk factors of de-scending-moderate group.Education levels with 1-6 years(B=-0.398,OR=0.672,95％CI=0.469-0.963),＞6 years(B=-1.072,OR=0.342,95％CI=0.229-0.513),being married(B=-0.476,OR=0.621,95％CI=0.444-0.870),self-reported good health(B=-0.808,OR=0.446,95％CI=0.213-0.932),improved health status(B=-0.704,OR=0.495,95％CI=0.320-0.766),self-reported average eco-nomic status(B=-1.065,OR=0.345,95％CI=0.148-0.802),self-reported good economic status(B=-1.634,OR=0.195,95％CI=0.082-0.467),and a higher cognition score(B=-0.142,OR=0.867,95％CI=0.798-0.942)served as protective factors of descending-moderate group.In addition to the above factors,being in the age group of 75-89 years(B=0.481,OR=1.617,95％CI=1.057-2.473)was a risk factor for decreasing-high group compared to stable-low group.Conclusions Three types of self-neglect be-havior trajectories among older adults were identified in this study,suggesting that physical health and econo-my are the influencing factors of the development trajectory of self-neglect of the elderly.
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