老年失能分类评估标准指南（2023版）

Guidelines for categorical assessment of disability in old age (2023 edition)

摘要:

当今全球正面临日益严峻的老龄化问题，中国尤为显著。老年人群成为失能的主体人群，随着失能老年人口的持续增长，对照料和护理的需求也随之上升，这不仅增加了个人和家庭的经济负担，也对社会造成了压力。大量研究证明，对老年失能进行早期的准确评估和干预是减缓失能进程的有效途径。目前，国内外尚无专门针对老年人失能分类评估的指南。尽管一些现有的指南涉及了部分老年失能相关的评估内容，但并未严格遵循《国际功能、残疾和健康分类》（ICF）框架，也未能全面把握失能的整体特征，因此在我国临床实践中的应用效果并不理想。为填补这一空白，该指南旨在综合现有的循证医学证据，同时充分考虑中国失能老年人的价值观和偏好，采用推荐意见评估、制订及评价（GRADE）分级体系，制订适合中国国情的《老年失能分类评估标准指南》。最终形成了12条针对失能老年人的评估推荐意见，以期早期发现老年失能并采取干预措施，延缓失能的进展，助力健康老龄化。

Abstract:

Nowadays， many countries around the world are facing the problem of population ageing， especially China. Older adults have become the main population with disability， and with the constant increase in the elderly population with disability， there is an increasing demand for care and nursing， which not only imposes a great economic burden on individuals and their families， but also causes pressure to the society. A large number of studies have shown that early accurate assessment and intervention for disability-related conditions in older adults are effective measures to delay the progression of disability， while at present， there are still no specific guidelines for the categorical assessment of disability in older adults in China or around the world. Although some existing guidelines cover several aspects of disability-related assessment， they do not strictly follow the framework of International Classification of Functioning， Disability， and Health and fail to grasp the overall characteristics of disability-related conditions， and therefore， such guidelines show an unsatisfactory application effect in Chinese clinical practice. To fill in this gap， the guidelines for categorical assessment of disability in old age suitable for the national conditions of China are developed based on existing evidence-based medicine evidence and the values and preferences of older adults in China， with the application of Grading of Recommendations Assessment， Development and Evaluation. Finally， 12 recommendations are formed for the assessment of older adults with disability， in order to identify the older adults with disability and perform interventions in the early stage， delay the progression of disability， and contribute to healthy aging.