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Prev Chronic Dis. 2017 Sep 7;14:E76. doi: 10.5888/pcd14.160613.
Adults with multiple (≥2) chronic conditions (MCCs) account for a large portion of US health care costs. Despite the increase in MCC rates with age, most people with MCCs are working age. The study objective was to compare adults with MCCs who were younger than 65 years with those aged 65 years or older on selected measures to better understand the differences between groups and inform interventions that could lower health care costs.
Data from respondents to the 2015 Behavioral Risk Factor Surveillance System data (N = 201,711) were used to compare adults aged 65 or older with MCCs with those younger than 65 with MCCs in unadjusted and adjusted analyses on chronic conditions, quality of life measures, disability status, access to health care, and modifiable risk factors. MCCs were based on up to 12 chronic conditions (heart disease, stroke, asthma, arthritis, chronic obstructive pulmonary disease, high cholesterol, cognitive impairment, diabetes, depression, chronic kidney disease, cancer other than skin, and hypertension).
Consistent with 80% of all adults being younger than 65, more than 60% of adults with MCCs were younger than 65 years. Compared with adults aged 65 or older with MCCs, those younger than 65 were more likely to report asthma, cognitive impairment, depression, smoking, obesity, poorer access to health care, disability, and worse quality of life in both unadjusted and adjusted analysis.
To decrease the burden of chronic diseases, adults younger than 65 with MCCs should get the treatment they need to reduce the chance of developing more chronic conditions as they age. The ultimate goal is to improve health status and reduce health care costs for everyone with MCCs.
患有多种（≥2 种）慢性疾病（MCC）的成年人占美国医疗保健费用的很大一部分。尽管随着年龄的增长，MCC 的发病率有所增加，但大多数患有 MCC 的人仍处于工作年龄。本研究的目的是比较年龄在 65 岁以下和 65 岁及以上的患有 MCC 的成年人在某些指标上的差异，以更好地了解两组人群之间的差异，并为降低医疗保健成本的干预措施提供信息。
使用来自 2015 年行为风险因素监测系统数据（N=201711）的受访者数据，在未调整和调整分析中比较年龄在 65 岁或以上且患有 MCC 的成年人与年龄在 65 岁以下且患有 MCC 的成年人之间的慢性疾病、生活质量指标、残疾状况、获得医疗保健的机会和可改变的危险因素。MCC 是基于多达 12 种慢性疾病（心脏病、中风、哮喘、关节炎、慢性阻塞性肺疾病、高胆固醇、认知障碍、糖尿病、抑郁、慢性肾病、非皮肤癌和高血压）。
由于 80%的成年人年龄都小于 65 岁，所以超过 60%的患有 MCC 的成年人年龄都小于 65 岁。与年龄在 65 岁或以上且患有 MCC 的成年人相比，年龄在 65 岁以下且患有 MCC 的成年人在未调整和调整分析中更有可能报告哮喘、认知障碍、抑郁、吸烟、肥胖、获得医疗保健的机会较差、残疾和生活质量较差。
为了减轻慢性病的负担，年龄在 65 岁以下且患有 MCC 的成年人应该接受治疗，以降低随着年龄增长而患上更多慢性疾病的机会。最终目标是改善所有患有 MCC 的人的健康状况并降低医疗保健成本。
