Su Peng, Ding Hansheng, Zhang Wei, Duan Guangfeng, Yang Yitong, Chen Rong, Duan Zengjie, Du Lixia, Xie Chunyan, Jin Chunlin, Hu Chaoqun, Sun Zixue, Long Junrui, Gong Lingling, Tian Wenhua
Department of Medical Administration, Guangzhou General Hospital of P.L.A., Guangzhou, 510010, China.
Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.
BMC Geriatr. 2016 Oct 27;16(1):178. doi: 10.1186/s12877-016-0352-9.
Both multimorbidity and activities of daily living (ADL) disability and instrument activities of daily living (IADL) disability are common among elderly individuals. ADL/IADL disability may reduce individuals' capacities for independent living and quality of life. This study aimed to examine the association between multimorbidity and ADL/IADL disability.
A multi-stage cluster sample of 2058 residents aged 80 or older was investigated in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases with ten common chronic conditions under consideration. Subjects who responded that they "need partial or full assistance" to any ADL/IADL items were defined as having ADL/IADL disability. We examined the association of multimorbidity with ADL/IADL disability, adjusted for socio-demographic characteristics by using logistic regression.
Of respondents, 23.23 % had ADL disability, 37.90 % had IADL disability, and 49.17 % had multimorbidity. After adjusted socio-demographic characteristics, a graded association was showed between ADL disability and the quantity of chronic conditions: odds ratio (OR) for 1 condition, 1.53(95 % confidence interval [CI], 1.04-2.24); OR for 2 conditions, 2.06(95 % CI, 1.43-2.96); OR for 3 conditions, 3.23(95 % CI, 2.14-4.86); OR for 4 or more conditions, 5.61(95 % CI, 3.26-9.66). Similar associations were also observed between the quantity of chronic conditions and IADL disability.
The quantity of chronic conditions had relatively strong association with both ADL and IADL disability. Initiating prevention of additional chronic conditions and interventions on clusters of diseases may decrease the potential risk of ADL/IADL disability. Additionally, more attention should been given to the older low-income women living with relatives/non-relatives with multimorbidity.
共病以及日常生活活动（ADL）残疾和工具性日常生活活动（IADL）残疾在老年人中都很常见。ADL/IADL残疾可能会降低个体的独立生活能力和生活质量。本研究旨在探讨共病与ADL/IADL残疾之间的关联。
在中国上海对2058名80岁及以上居民进行了多阶段整群抽样调查。共病被定义为同时存在两种或更多种所考虑的十种常见慢性病。对任何ADL/IADL项目回答“需要部分或全部帮助”的受试者被定义为患有ADL/IADL残疾。我们通过逻辑回归分析了共病与ADL/IADL残疾之间的关联，并对社会人口学特征进行了调整。
在受访者中，23.23%有ADL残疾，37.90%有IADL残疾，49.17%有共病。在调整社会人口学特征后，ADL残疾与慢性病数量之间呈现出分级关联：1种慢性病的比值比（OR）为1.53（95%置信区间[CI]，1.04 - 2.24）；2种慢性病的OR为2.06（95% CI，1.43 - 2.96）；3种慢性病的OR为3.23（95% CI，2.14 - 4.86）；4种或更多种慢性病的OR为5.61（95% CI，3.26 - 9.66）。在慢性病数量与IADL残疾之间也观察到了类似的关联。
慢性病数量与ADL和IADL残疾均有较强关联。预防新增慢性病以及对疾病群组进行干预可能会降低ADL/IADL残疾的潜在风险。此外，应更多关注与亲属/非亲属共同生活且患有共病的老年低收入女性。
