Lu Feng-Ping, Chang Wen-Chiung, Wu Shwu-Chong
Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, College of Medicine, Taipei, Taiwan.
Geriatr Gerontol Int. 2016 Mar;16(3):345-51. doi: 10.1111/ggi.12480. Epub 2015 Apr 23.
To examine the impact of geriatric conditions and multimorbidity on the risk of incident disability and mortality among young-old and old-old adults.
The present study used nationally-representative data from the "Survey of Health and Living Status of the Elderly in Taiwan" for the years 2003 and 2007. Non-disabled older adults were divided into two age groups (65-79 years and ≥80 years). Chronic morbidities and geriatric conditions were assessed in 2003. Incident disability was defined as dependency in one or more activities of daily living in 2007. Vital statistics of the participants was linked to death registration data through 31 December 2007. Multivariable logistic regression and Cox regression were used to determine the effect of multimorbidity and geriatric conditions on health outcomes.
Among those aged 65-79 years (n = 1874), the presentation of multimorbidity or two or more geriatric conditions was related to incident disability. Among octogenarians, the presentation of one or more geriatric conditions, but not multimorbidity, was shown to be independently associated with the risk of disability. Multimorbidity was related to a higher adjusted risk of mortality in the young-old group (hazard ratio 1.54; 95% confidence interval 1.1-2.2) but not in the old-old group. Among octogenarians, those with two or more geriatric conditions had a higher adjusted risk of mortality (hazard ratio 1.7; 95% confidence interval 1.2-2.5), compared with those with 0-1 geriatric conditions.
The risk of incident disability and mortality increased in octogenarians with geriatric conditions, but not in cases with multimorbidity.
探讨老年疾病和多种疾病并存对年轻老年人和高龄老年人发生残疾和死亡风险的影响。
本研究使用了2003年和2007年“台湾老年人健康与生活状况调查”的全国代表性数据。非残疾老年人被分为两个年龄组(65 - 79岁和≥80岁)。2003年评估了慢性疾病和老年疾病。2007年将日常生活活动中一项或多项活动需要依赖定义为发生残疾。参与者的生命统计数据与截至2007年12月31日的死亡登记数据相关联。采用多变量逻辑回归和Cox回归来确定多种疾病并存和老年疾病对健康结局的影响。
在65 - 79岁的人群中(n = 1874),多种疾病并存或两种及以上老年疾病与发生残疾有关。在八旬老人中,一种或多种老年疾病的存在而非多种疾病并存被证明与残疾风险独立相关。多种疾病并存与年轻老年人组调整后较高的死亡风险相关(风险比1.54;95%置信区间1.1 - 2.2),但在高龄老年人组中并非如此。在八旬老人中,与患有0 - 1种老年疾病的人相比,患有两种及以上老年疾病的人调整后的死亡风险更高(风险比1.7;95%置信区间1.2 - 2.5)。
患有老年疾病的八旬老人发生残疾和死亡的风险增加,但多种疾病并存的情况并非如此。