Jones Salene M W, Amtmann Dagmar, Gell Nancy M
a Group Health Research Institute , Seattle , WA , USA.
b Department of Rehabilitation Medicine , University of Washington , Seattle , WA , USA.
Aging Ment Health. 2016;20(3):309-17. doi: 10.1080/13607863.2015.1008988. Epub 2015 Feb 12.
Multimorbidity, the presence of multiple chronic medical conditions, is particularly prevalent in older adults. We examined the relationship of multimorbidity with mental health, social network and activity limitations in the National Health and Aging Trends Study, a nationally representative, age-stratified sample of older adults.
After excluding participants who used a proxy to complete the survey and those who did not answer any of the depressive symptoms, anxiety symptoms and positive and negative affect items, the final sample was 7026. A disease count of 10 conditions (heart disease, hypertension, arthritis, osteoporosis, diabetes, lung disease, stroke, dementia, cancer, fracture) was used.
Factor analysis indicated a one factor structure for disease count was tenable, although cancer did not appear to fit the model. Therefore, a count of the nine other diseases was used. Disease count was related to increased depressive symptoms, anxiety symptoms and negative affect and less positive affect. All individual diseases including cancer were related to worse mental health as was having two or more conditions. Disease count, having two or more conditions and several individual diseases (heart disease, hypertension, arthritis, cancer and fracture) were also related to increases in social network size while other individual diseases (osteoporosis, diabetes, lung disease, stroke and dementia) were related to decreases in social network size. All the measures of multimorbidity and individual diseases were associated with the increased odds of activity limitations.
Results support a broader focus for older adults with multimorbidity that includes mental health needs.
多种慢性病并存，即存在多种慢性疾病，在老年人中尤为普遍。我们在美国国家健康与老龄化趋势研究中，对多种慢性病与心理健康、社交网络及活动受限之间的关系进行了研究，该研究是一项具有全国代表性的、按年龄分层的老年人样本研究。
在排除使用代理人完成调查的参与者以及未回答任何抑郁症状、焦虑症状及正负性情感项目的参与者后，最终样本为7026人。使用了10种疾病（心脏病、高血压、关节炎、骨质疏松症、糖尿病、肺部疾病、中风、痴呆症、癌症、骨折）的疾病计数。
因子分析表明疾病计数的单因素结构是成立的，尽管癌症似乎不适合该模型。因此，使用了其他9种疾病的计数。疾病计数与抑郁症状增加、焦虑症状增加、负性情感增加以及正性情感减少有关。包括癌症在内的所有个体疾病以及患有两种或更多种疾病均与较差的心理健康有关。疾病计数、患有两种或更多种疾病以及几种个体疾病（心脏病、高血压、关节炎、癌症和骨折）也与社交网络规模的增加有关，而其他个体疾病（骨质疏松症、糖尿病、肺部疾病、中风和痴呆症）与社交网络规模的减少有关。多种慢性病及个体疾病的所有测量指标均与活动受限几率增加有关。
结果支持对患有多种慢性病的老年人给予更广泛的关注，其中包括心理健康需求。
