2024 年第 4 期 第 19 卷

老年人叶酸补充现状调查及影响因素分析

Investigation on the current situation of folic acid supplementation in elderly people and analysis of influencing factors

作者：李亚冬张金鑫马立萍

英文作者：Li Yadong Zhang Jinxin Ma Liping

单位：首都医科大学附属北京安贞医院全科医疗科，北京100029

英文单位：Department of General Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：叶酸补充；老年人；影响因素

英文关键词：Folicacidsupplementation;Elderlypeople;Influencingfactors

• 摘要：

• 目的 了解老年人补充叶酸现状并分析影响因素，为引导老年人正确补充叶酸提供参考。方法 以方便抽样法选取2023年3月1—31日于首都医科大学附属北京安贞医院就诊的60岁及以上处方含叶酸的老年人为研究对象，采用问卷调查法获取其对叶酸补充的知信行情况。统计老年人对于叶酸认识程度以及服用叶酸的现状；以被调查者平均每日叶酸补充剂量是否合理分为合理补充组和不合理补充组，比较2组调查对象特征；通过Logistic回归分析方法分析合理补充叶酸的影响因素。结果 共发放问卷673份，回收有效问卷595份。595例被调查者中男359例、女236例，年龄（70±6）岁；合理补充组280例，不合理补充组315例。合理补充组的男性比例、文化程度、合并高血压病比例、检测过血清同型半胱氨酸、检测过血清叶酸、知晓过量补充叶酸可能带来健康风险的比例及叶酸知识的获取途径为医师主动处方的比例高于不合理补充组，差异均有统计学意义（均P<0.05）。多因素Logistic回归分析结果显示年龄小于70岁（比值比=0.014，95%置信区间：0.013～0.128）、本科及以上的文化程度（比值比=0.147，95%置信区间：0.060～0.356）、知晓过量补充叶酸带来的健康风险（比值比=0.029,95%置信区间：0.009～0.091）、叶酸补充由医师主动处方（比值比=0.062,95%置信区间：0.024～0.175）对老年人合理补充叶酸有明显积极影响（均P<0.05）。结论 加强叶酸补充相关知识的健康教育，由医师进行个体化叶酸处方更有利于老年人合理补充叶酸，从而得到相关获益，避免健康风险。

• Objective To understand the current situation and analyze the influencing factors of folic acid supplementation in elderly people, and to provide reference for guiding them to correctly supplement folic acid. Methods Elderly people aged over 60 and above who had prescribed folic acid at Beijing Anzhen Hospital, Capital Medical University from March 1 to 31, 2023 were selected as the study subjects using convenience sampling method. Their knowledge, belief, and behavior regarding folic acid supplementation were obtained using a questionnaire survey method. The level of understanding of folic acid among the elderly and the current status of taking folic acid are statistically analyzed; the respondents were divided into reasonable supplement group and unreasonable supplement group based on whether the average daily supplementation dose of folic acid was reasonable, and the characteristics of the two groups were compared. The influencing factors of reasonable supplementation of folic acid were analyzed using Logistic regression analysis method. Results A total of 673 questionnaires were distributed and 595 valid questionnaires were collected. The 595 respondents included 359 males and 236 females, and the age was (70±6) years old. There were 280 people in the reasonable supplement group and 315 people in the unreasonable supplementation group. The proportions of male, educational level, the proportion of concomitant hypertension, the proportion of tested serum homocysteine, tested serum folic acid, and the proportion of knowing the possible health risks caused by excessive supplementation of folic acid, as well as the proportion of physicians actively prescribing folic acid knowledge in the reasonable supplementation group were higher than those in the unreasonable supplementation group(all P<0.05). The results of multivariate Logistic regression analysis showed that age below 70 years old(odds ratio=0.014, 95% confidence interval: 0.013-0.128), education level at or above undergraduate level(odds ratio=0.147, 95% confidence interval: 0.060-0.356), awareness of the health risks associated with excessive folic acid supplementation(odds ratio=0.029, 95% confidence interval: 0.009-0.091), folic acid supplementation prescribed by physicians actively (odds ratio=0.062, 95% confidence interval: 0.024-0.175) has a significant positive impact on the rational supplementation of folic acid in elderly people(all P<0.05). Conclusions Strengthening health education on knowledge related to folic acid supplementation and individualized folic acid prescriptions by doctors are more beneficial for elderly people to reasonably supplement folic acid, thereby gaining relevant benefits and avoiding health risks.