Garin Noe, Olaya Beatriz, Perales Jaime, Moneta Maria Victoria, Miret Marta, Ayuso-Mateos Jose Luis, Haro Josep Maria
Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain ; Fundació Sant Joan de Déu, Esplugues de Llobregat, Spain ; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain ; Fundació Sant Joan de Déu, Esplugues de Llobregat, Spain.
PLoS One. 2014 Jan 20;9(1):e84794. doi: 10.1371/journal.pone.0084794. eCollection 2014.
In the context of population aging, multimorbidity has emerged as a growing concern in public health. However, little is known about multimorbidity patterns and other issues surrounding chronic diseases. The aim of our study was to examine multimorbidity patterns, the relationship between physical and mental conditions and the distribution of multimorbidity in the Spanish adult population.
Data from this cross-sectional study was collected from the COURAGE study. A total of 4,583 participants from Spain were included, 3,625 aged over 50. An exploratory factor analysis was conducted to detect multimorbidity patterns in the population over 50 years of age. Crude and adjusted binary logistic regressions were performed to identify individual associations between physical and mental conditions.
THREE MULTIMORBIDITY PATTERNS ROSE: 'cardio-respiratory' (angina, asthma, chronic lung disease), 'mental-arthritis' (arthritis, depression, anxiety) and the 'aggregated pattern' (angina, hypertension, stroke, diabetes, cataracts, edentulism, arthritis). After adjusting for covariates, asthma, chronic lung disease, arthritis and the number of physical conditions were associated with depression. Angina and the number of physical conditions were associated with a higher risk of anxiety. With regard to multimorbidity distribution, women over 65 years suffered from the highest rate of multimorbidity (67.3%).
Multimorbidity prevalence occurs in a high percentage of the Spanish population, especially in the elderly. There are specific multimorbidity patterns and individual associations between physical and mental conditions, which bring new insights into the complexity of chronic patients. There is need to implement patient-centered care which involves these interactions rather than merely paying attention to individual diseases.
在人口老龄化的背景下，多病共存已成为公共卫生领域日益关注的问题。然而，对于多病共存模式以及围绕慢性病的其他问题，人们知之甚少。我们研究的目的是调查西班牙成年人群中的多病共存模式、身心状况之间的关系以及多病共存的分布情况。
本横断面研究的数据来自COURAGE研究。共纳入了4583名来自西班牙的参与者，其中3625名年龄在50岁以上。对50岁以上人群进行探索性因素分析以检测多病共存模式。进行了粗回归和调整后的二元逻辑回归以确定身心状况之间的个体关联。
出现了三种多病共存模式：“心肺型”（心绞痛、哮喘、慢性肺病）、“精神-关节炎型”（关节炎、抑郁症、焦虑症）和“综合型”（心绞痛、高血压、中风、糖尿病、白内障、无牙症、关节炎）。在调整协变量后，哮喘、慢性肺病、关节炎和身体疾病数量与抑郁症相关。心绞痛和身体疾病数量与焦虑症风险较高相关。关于多病共存分布，65岁以上女性的多病共存率最高（67.3%）。
多病共存现象在西班牙人群中普遍存在，尤其是在老年人中。存在特定的多病共存模式以及身心状况之间的个体关联，这为慢性病患者的复杂性带来了新的见解。需要实施以患者为中心的护理，其中涉及这些相互作用，而不仅仅是关注个体疾病。
