Botes Riaan, Vermeulen Karin M, Correia Janine, Buskens Erik, Janssen Fanny
Clinical Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
BMC Health Serv Res. 2018 Jan 15;18(1):24. doi: 10.1186/s12913-017-2820-0.
The amount of time spent living with disease greatly influences elderly people's wellbeing, disability and healthcare costs, but differs by disease, age and sex.
We assessed how various single and combined diseases differentially affect life years spent living with disease in Dutch elderly men and women (65+) over their remaining life course. Multistate life table calculations were applied to age and sex-specific disease prevalence, incidence and death rates for the Netherlands in 2007. We distinguished congestive heart failure, coronary heart disease (CHD), breast and prostate cancer, colon cancer, lung cancer, diabetes, COPD, stroke, dementia and osteoarthritis.
Across ages 65, 70, 75, 80 and 85, CHD caused the most time spent living with disease for Dutch men (from 7.6 years at age 65 to 3.7 years at age 85) and osteoarthritis for Dutch women (from 11.7 years at age 65 to 4.8 years at age 85). Of the various co-occurrences of disease, the combination of diabetes and osteoarthritis led to the most time spent living with disease, for both men (from 11.2 years at age 65 to 4.9 -years at age 85) and women (from 14.2 years at age 65 to 6.0 years at age 85).
Specific single and multi-morbid diseases affect men and women differently at different phases in the life course in terms of the time spent living with disease, and consequently, their potential disability. Timely sex and age-specific interventions targeting prevention of the single and combined diseases identified could reduce healthcare costs and increase wellbeing in elderly people.
与疾病共存的时间长短对老年人的幸福感、残疾状况和医疗费用有很大影响，但因疾病、年龄和性别而异。
我们评估了各种单一疾病和合并疾病如何不同程度地影响荷兰65岁及以上老年男性和女性在其剩余生命历程中与疾病共存的生命年数。运用多状态生命表计算方法，依据2007年荷兰特定年龄和性别的疾病患病率、发病率及死亡率进行分析。我们区分了充血性心力衰竭、冠心病（CHD）、乳腺癌和前列腺癌、结肠癌、肺癌、糖尿病、慢性阻塞性肺疾病（COPD）、中风、痴呆症和骨关节炎。
在65岁、70岁、75岁、80岁和85岁各年龄段，冠心病导致荷兰男性与疾病共存的时间最长（从65岁时的7.6年到85岁时的3.7年），骨关节炎导致荷兰女性与疾病共存的时间最长（从65岁时的11.7年到85岁时的4.8年）。在各种疾病共存情况中，糖尿病和骨关节炎的组合导致男性（从65岁时的11.2年到85岁时的4.9年）和女性（从65岁时的14.2年到85岁时的6.0年）与疾病共存的时间最长。
特定的单一疾病和多病共存情况在生命历程的不同阶段对男性和女性与疾病共存的时间有不同影响，进而影响其潜在的残疾状况。针对已确定的单一疾病和合并疾病进行及时的针对性别和年龄的干预，可降低医疗费用并提高老年人的幸福感。
