Boeckxstaens Pauline, Vaes Bert, De Sutter An, Aujoulat Isabelle, van Pottelbergh Gijs, Matheï Catharina, Degryse Jean-Marie
Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
Institut de Recherche Santé et Société, Université Catholique de Louvain, Brussels, Belgium Department of Public Health and Primary care, Katholieke Universiteit Leuven, Leuven, Belgium.
Ann Fam Med. 2016 Jul;14(4):337-43. doi: 10.1370/afm.1950.
We set out to assess whether a high sense of coherence (SOC) protects from adverse health outcomes in patients aged 80 years and older who have multiple chronic diseases.
A population-based prospective cohort study in 29 primary care practices throughout Belgium included 567 individuals aged 80 years and older. We plotted the highest tertile of SOC scores in Kaplan-Meier curves representing 3-year mortality and time to first hospitalization. Using Cox proportional hazard regression analyses and multiple logistic regression analyses adjusted for sociodemographic characteristics, depression, cognition, disability, and multimorbidity we examined the relationship between SOC and mortality, hospitalization, and decline in performance of activities of daily living (ADL).
Subjects with high SOC scores showed a higher cumulative survival than others (Log rank = 0.004) independent of other prognostic characteristics (adjusted hazard ratio 0.62 (95% CI, 0.38-1.00), P = .049). For ADL decline, a high SOC was shown to be protective, and this effect tended to be independent from the covariates under study (adjusted odds ratio 0.56 (95% CI, 0.31-1.0), P = .05).
Even very elderly persons with high SOC scores were shown to have lower mortality rates and less functional decline. These effects were independent of multimorbidity, depression, cognition, disability, and sociodemographic characteristics.
我们旨在评估高连贯感（SOC）是否能保护患有多种慢性病的80岁及以上患者免受不良健康后果的影响。
在比利时全国29个初级保健机构开展的一项基于人群的前瞻性队列研究纳入了567名80岁及以上的个体。我们将SOC得分最高的三分位数绘制在代表3年死亡率和首次住院时间的Kaplan-Meier曲线上。使用Cox比例风险回归分析和针对社会人口学特征、抑郁、认知、残疾和多种疾病进行调整的多元逻辑回归分析，我们研究了SOC与死亡率、住院率以及日常生活活动（ADL）能力下降之间的关系。
SOC得分高的受试者显示出比其他受试者更高的累积生存率（对数秩检验=0.004），且独立于其他预后特征（调整后的风险比为0.62（95%CI，0.38 - 1.00），P = 0.049）。对于ADL能力下降，高SOC显示出具有保护作用，且这种效应往往独立于所研究的协变量（调整后的优势比为0.56（95%CI，0.31 - 1.0），P = 0.05）。
即使是SOC得分高的高龄老人也显示出较低的死亡率和较少的功能衰退。这些效应独立于多种疾病、抑郁、认知、残疾和社会人口学特征。
