Kim Kwang-Il, Lee Ju Hyun, Kim Cheol-Ho
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Gend Med. 2012 Oct;9(5):309-18. doi: 10.1016/j.genm.2012.08.001. Epub 2012 Aug 31.
Multimorbidity is a common problem in elderly populations and is significantly associated with functional decline, disability, and mortality. However, the sex-specific characteristics of multimorbidity and its effect on patients' quality of life (QOL) have not been clearly established.
We analyzed the Korean National Health and Nutrition Examination Survey database. EuroQol 5D (a standardized health outcomes measurement instrument that includes 2 dimensions, the EuroQol 5 Dimension [EQ-5D] index score and the EuroQol visual analogue scale [EQ-VAS]) was used to evaluate QOL. Multimorbidity was evaluated using data on blood pressure measurements, blood chemistry examinations, and anthropometric assessments, as well as a survey that assessed health status.
A total of 1419 patients aged ≥65 years were included in the analysis (age = 72.40 [0.19] years; 39.3% men). Multimorbidity was significantly associated with being a woman; however, it was not associated with age. The EQ-5D index score and EQ-VAS score were significantly lower in patients with multimorbidity, especially among the elderly women. The inverse association between QOL and the number of chronic diseases was maintained without a floor effect. Hypertension was the most common disease; however, QOL was significantly associated with musculoskeletal disease, stroke, and depression, all of which were more common in female patients. There was no significant difference in QOL between men and women with similar levels of comorbidity.
Both the amount and pattern of chronic diseases have been associated with QOL in elderly populations. Elderly women have low levels of QOL due to multimorbidity and a higher prevalence of chronic disease, which is related to impaired QOL.
多病共存是老年人群中的常见问题,与功能衰退、残疾和死亡率显著相关。然而,多病共存的性别特异性特征及其对患者生活质量(QOL)的影响尚未明确。
我们分析了韩国国家健康与营养检查调查数据库。使用欧洲五维健康量表(EuroQol 5D,一种标准化的健康结局测量工具,包括两个维度,即欧洲五维健康量表[EQ-5D]指数得分和欧洲五维健康量表视觉模拟量表[EQ-VAS])来评估生活质量。使用血压测量、血液化学检查、人体测量评估数据以及评估健康状况的调查来评估多病共存情况。
共有1419名年龄≥65岁的患者纳入分析(年龄 = 72.40[0.19]岁;男性占39.3%)。多病共存与女性显著相关;然而,与年龄无关。多病共存患者的EQ-5D指数得分和EQ-VAS得分显著较低,尤其是老年女性。生活质量与慢性病数量之间的负相关关系持续存在,且无下限效应。高血压是最常见的疾病;然而,生活质量与肌肉骨骼疾病、中风和抑郁症显著相关,所有这些在女性患者中更为常见。合并症水平相似的男性和女性在生活质量方面没有显著差异。
慢性病的数量和模式均与老年人群的生活质量相关。老年女性由于多病共存和慢性病患病率较高,生活质量较低,这与生活质量受损有关。