Ness Jose, Cirillo Dominic J, Weir David R, Nisly Nicole L, Wallace Robert B
Department of Internal Medicine, University of Iowa Carver College of Medicine, SE624GH, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Gerontologist. 2005 Aug;45(4):516-24. doi: 10.1093/geront/45.4.516.
The correlates of complementary and alternative medicine (CAM) utilization among elders have not been fully investigated. This study was designed to identify such correlates in a large sample of older adults, thus generating new data relevant to consumer education, medical training, and health practice and policy.
A subsample from the 2000 Wave of the Health and Retirement Study (n = 1,099) aged 52 or older were surveyed regarding use of CAM (chiropractic, alternative practitioners, dietary and herbal supplements, and personal practices).
Of respondents over 65 years of age, 88% used CAM, with dietary supplements and chiropractic most commonly reported (65% and 46%, respectively). Users of alternate practitioners and dietary supplements reported having more out-of-pocket expenses on health than nonusers of these modalities. Age correlated positively with use of dietary supplements and personal practices and inversely with alternative practitioner use. Men reported less CAM use than women, except for chiropractic and personal practices. Blacks and Hispanics used fewer dietary supplements and less chiropractic, but they reported more personal practices than Whites. Advanced education correlated with fewer chiropractic visits and more dietary and herbal supplement and personal practices use. Higher income, functional impairment, alcohol use, and frequent physician visits correlated with more alternative practitioner use. There was no association between CAM and number of chronic diseases.
The magnitude and patterns of CAM use among elders lend considerable importance to this field in public health policy making and suggest a need for further epidemiological research and ongoing awareness efforts for both patients and providers.
老年人使用补充和替代医学（CAM）的相关因素尚未得到充分研究。本研究旨在在大量老年人样本中确定这些相关因素，从而生成与消费者教育、医学培训以及健康实践和政策相关的新数据。
对来自2000年健康与退休研究（Health and Retirement Study）第2轮调查中年龄在52岁及以上的一个子样本（n = 1,099）进行了关于CAM使用情况（整脊疗法、替代疗法从业者、膳食和草药补充剂以及个人保健方法）的调查。
在65岁以上的受访者中，88%使用CAM，其中最常报告使用的是膳食补充剂和整脊疗法（分别为65%和46%）。使用替代疗法从业者和膳食补充剂的人报告在健康方面的自付费用比未使用这些方式的人更多。年龄与膳食补充剂和个人保健方法的使用呈正相关，与替代疗法从业者的使用呈负相关。除整脊疗法和个人保健方法外，男性报告的CAM使用少于女性。黑人和西班牙裔使用的膳食补充剂较少，整脊疗法也较少，但他们报告的个人保健方法比白人更多。高等教育与较少的整脊治疗就诊次数以及更多的膳食和草药补充剂及个人保健方法的使用相关。较高收入、功能障碍、饮酒以及频繁就医与更多地使用替代疗法从业者相关。CAM的使用与慢性病数量之间没有关联。
老年人中CAM使用的规模和模式在公共卫生政策制定中赋予了该领域相当大的重要性，并表明需要进一步开展流行病学研究以及持续提高患者和医疗服务提供者的认识。
