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阿尔茨海默病的负担及其与不良健康结局的关联。

Burden of Alzheimer's disease and association with negative health outcomes.

作者信息

Malone Daniel C, McLaughlin Trent P, Wahl Peter M, Leibman Christopher, Arrighi H Michael, Cziraky Mark J, Mucha Lisa M

机构信息

College of Pharmacy, University of Arizona, Tucson, AZ 85721-0202, USA.

出版信息

Am J Manag Care. 2009 Aug;15(8):481-8.

Abstract

OBJECTIVE

To examine the association of Alzheimer's disease (AD) with common chronic conditions, acute care events, and risk of hospitalization.

STUDY DESIGN

Retrospective matched cohort analysis.

METHODS

Community-dwelling subjects with a diagnosis of and/or medication for AD were matched to subjects without AD based on age, sex, and geographic region. Administrative claims from commercially insured health plans for medical and pharmacy services provided from January 1, 2000, to March 31, 2006 (inclusive) were analyzed. The Deyo Charlson Index (DCI) was used to assess the number of chronic conditions. The outcomes of interest were risk of fractures and hospitalization.

RESULTS

Among 5396 persons with AD and a matched cohort of 5396 persons without the condition, subjects with AD were more likely to have a diagnosis for any of the DCI components, had a higher rate of fractures (17.7% vs 7.9%, P <.00) and other urgent medical events (eg, pneumonia 14.0% vs 6.3%, P <.00), and were more likely to be hospitalized (odds ratio = 1.7; 95% confidence interval = 1.5, 1.9). There were significant differences in the medication use between the 2 groups, with the use of psychotics/tranquilizers 9-fold higher among persons with AD.

CONCLUSION

Persons with AD have higher odds of experiencing a fracture, being hospitalized, and requiring other acute care medical services than those without AD. The disease also is associated with a higher prevalence of common chronic conditions.

摘要

目的

研究阿尔茨海默病(AD)与常见慢性病、急性护理事件及住院风险之间的关联。

研究设计

回顾性匹配队列分析。

方法

将诊断患有AD和/或正在接受AD治疗的社区居住受试者,根据年龄、性别和地理区域与未患AD的受试者进行匹配。分析了2000年1月1日至2006年3月31日(含)期间商业保险健康计划提供的医疗和药房服务的行政索赔数据。使用Deyo Charlson指数(DCI)评估慢性病的数量。感兴趣的结果是骨折和住院风险。

结果

在5396名患有AD的人和5396名匹配的未患AD的队列中,患有AD的受试者更有可能被诊断出患有DCI的任何组成部分,骨折发生率更高(17.7%对7.9%,P<.00)以及其他紧急医疗事件(如肺炎14.0%对6.3%,P<.00),并且更有可能住院(比值比=1.7;95%置信区间=1.5,1.9)。两组之间的药物使用存在显著差异,AD患者使用精神药物/镇静剂的比例高出9倍。

结论

与未患AD的人相比,患有AD的人发生骨折、住院以及需要其他急性护理医疗服务的几率更高。该疾病还与常见慢性病的较高患病率相关。

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