London Andrew S, Landes Scott D
Syracuse University, Maxwell School of Citizenship & Public Affairs, Department of Sociology, Aging Studies Institute, and Center for Policy Research, 314 Lyman Hall, Syracuse, NY 13244-1020, United States.
University of North Florida, Department of Sociology, Anthropology, and Social Work, 1 UNF Drive, Jacksonville, FL 32224-7699, United States.
Prev Med. 2016 Sep;90:8-10. doi: 10.1016/j.ypmed.2016.06.021. Epub 2016 Jun 22.
This study examines the relationship between self-reported ADHD and adult mortality over a four-year period, and whether ADHD is associated with underlying cause of death (accidents versus all others). If ADHD increases mortality risk through accidents, then interventions may be designed and implemented to reduce risk and prevent premature death. We estimate descriptive statistics and multivariate logistic regression models using data from the 2007 U.S. National Health Interview Survey (NHIS) Sample Adult File linked to National Death Index (NDI) data through 2011 (N=23,352). Analyses are weighted and standard errors are adjusted for the complex sampling design. We find that the odds of dying are significantly higher among those with ADHD than among those without ADHD net of exogenous sociodemographic controls (adjusted odds ratio=1.78, 95% confidence interval=1.01, 3.12). Although marginally non-significant, accidental death is more common among those with ADHD than among those without ADHD (13.2% versus 4.3%, p=0.052). Few population-representative studies examine the relationship between ADHD and adult mortality due to data limitations. Using NHIS data linked to the NDI, we are only able to observe a few deaths among adults with ADHD. However, ADHD is associated with significantly higher odds of dying for adults and results suggest that accidents may be an underlying cause of death more often for decedents with ADHD. Future research should further examine the mechanisms linking ADHD to adult mortality and the extent to which mortality among persons with ADHD is preventable. Regular measurement of ADHD among adults in the NHIS is warranted.
本研究考察了自我报告的注意力缺陷多动障碍(ADHD)与四年期间成人死亡率之间的关系,以及ADHD是否与潜在死因(事故与其他所有死因)相关。如果ADHD通过事故增加死亡风险,那么可以设计并实施干预措施以降低风险并预防过早死亡。我们使用2007年美国国家健康访谈调查(NHIS)样本成人档案的数据估计描述性统计量和多变量逻辑回归模型,这些数据通过2011年与国家死亡指数(NDI)数据相链接(N = 23,352)。分析进行了加权处理,并针对复杂抽样设计调整了标准误差。我们发现,在排除外生社会人口统计学控制因素后,患有ADHD的人死亡几率显著高于未患ADHD的人(调整后的优势比 = 1.78,95%置信区间 = 1.01, 3.12)。虽然意外死亡在患有ADHD的人中比在未患ADHD的人中略为常见但不显著(13.2%对4.3%,p = 0.052)。由于数据限制,很少有具有人群代表性的研究考察ADHD与成人死亡率之间的关系。利用与NDI相链接的NHIS数据,我们仅能观察到少数患有ADHD的成年人死亡情况。然而,ADHD与成年人显著更高的死亡几率相关,结果表明事故可能更常是患有ADHD的死者的潜在死因。未来研究应进一步考察将ADHD与成人死亡率联系起来的机制,以及ADHD患者的死亡率在多大程度上是可预防的。有必要在NHIS中定期测量成年人的ADHD情况。