Garin Noe, Olaya Beatriz, Moneta Maria Victoria, Miret Marta, Lobo Antonio, Ayuso-Mateos Jose Luis, Haro Josep Maria
Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, 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, Barcelona, Spain.
PLoS One. 2014 Nov 6;9(11):e111498. doi: 10.1371/journal.pone.0111498. eCollection 2014.
Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends.
Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females.
All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [β for 4+ diseases: -18.10 (-20.95,-15.25)] and greater disability [β for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability.
Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with gender idiosyncrasy in certain cases.
在发达国家，人口老龄化与慢性病的高患病率密切相关。在此背景下，医疗保健政策旨在以具有成本效益的方式延长寿命，同时维持生活质量和功能能力。然而，仍需要进一步了解慢性病如何影响这些健康方面。本文的目的是评估慢性身体和精神疾病对西班牙生活质量和残疾的个体及综合影响，其次是展示性别趋势。
从“勇气”研究中收集横断面数据。纳入了来自西班牙的3625名50岁以上的参与者。进行了粗线性回归和调整后的多元线性回归，以检测个体慢性病与残疾之间以及慢性病与生活质量之间的关联。使用单独的模型评估疾病数量对相同变量的影响。对男性和女性进行了额外的类似回归分析。
除高血压外，所有慢性病在统计学上均与生活质量差和残疾相关。发现抑郁症、焦虑症和中风对结果的影响最大。慢性病的数量与显著更低的生活质量[4种及以上疾病的β值：-18.10（-20.95，-15.25）]和更大的残疾[4种及以上疾病的β值：27.64（24.99，30.29）]相关。总体而言，女性的多重疾病发生率更高，生活质量和残疾结果更差。
慢性病对西班牙老年人群的生活质量和残疾有很大影响，尤其是当合并疾病增加时。在制定未来关注生活质量和残疾的卫生政策时，应优先考虑多重疾病问题。进一步的研究将受益于更广泛的疾病选择。在某些情况下，政策还应考虑性别差异。
