在 80 岁及以上的老年人中，残疾比多种疾病更能预测死亡率。

Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older.

机构信息

Department of Gerontology and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.

出版信息

J Clin Epidemiol. 2010 Jul;63(7):752-9. doi: 10.1016/j.jclinepi.2009.09.007. Epub 2010 Jan 8.

DOI:10.1016/j.jclinepi.2009.09.007

PMID:20056387

Abstract

OBJECTIVE

In this study, we evaluate the impact of disability and multimorbidity on the risk of all-cause death in a population of frail older persons living in community.

STUDY DESIGN AND SETTING

We analyzed data from the Aging and Longevity Study in the Sirente geographic area, a prospective cohort study that collected data on all subjects aged 80 years and older (n=364). The main outcome measure was all-cause mortality over 4-year follow-up.

RESULTS

A total of 150 deaths occurred. Sixty-seven subjects (44.6%) died in the nondisabled group compared with 83 subjects (55.3%) in the disabled group (P<0.01). Thirty-nine subjects (31.7%) died among subjects without multimorbidity compared with 111 subjects (46.0%) with two or more diseases (P<0.01). When examining the combined effect of multimorbidity and disability, the effect of disability on the risk of death was higher than that of multimorbidity. After adjusting for potential confounders, relative to those without disability and multimorbidity, disabled subjects showed an increased risk of death when multimorbidity was associated (hazard ratio [HR]=3.91; 95% confidence interval [CI]=1.53-10.00) and in absence of multimorbidity (HR=2.36; 95% CI=0.63-8.83).

CONCLUSION

Our results show that disability exerts an important influence on mortality, independently of age and other clinical and functional variables.

摘要

目的

本研究旨在评估残疾和多病共存对社区居住的体弱老年人全因死亡风险的影响。

研究设计和设置

我们分析了 Sirente 地理区域老龄化和长寿研究的数据，这是一项前瞻性队列研究，收集了所有 80 岁及以上受试者的数据（n=364）。主要观察指标为 4 年随访期间的全因死亡率。

结果

共发生 150 例死亡。在无残疾组中，有 67 例（44.6%）受试者死亡，而在残疾组中，有 83 例（55.3%）受试者死亡（P<0.01）。在无多病共存的受试者中，有 39 例（31.7%）受试者死亡，而在有两种或两种以上疾病的受试者中，有 111 例（46.0%）受试者死亡（P<0.01）。当同时检查多病共存和残疾的综合影响时，残疾对死亡风险的影响大于多病共存。在调整潜在混杂因素后，与无残疾和多病共存的受试者相比，当多病共存与残疾相关时，残疾受试者的死亡风险增加（危险比[HR]=3.91；95%置信区间[CI]=1.53-10.00），而在无多病共存时，残疾受试者的死亡风险也增加（HR=2.36；95% CI=0.63-8.83）。