Whitney Daniel G, Hurvitz Edward A, Peterson Mark D
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Disabil Rehabil. 2020 Jul;42(15):2186-2191. doi: 10.1080/09638288.2018.1555720. Epub 2019 Jan 17.
This study examined whether depressive symptoms and sleep disorders modified the association between functional disabilities and cardiometabolic disease profiles in middle-aged adults (40-64 years). Participants came from the 2007-2014 NHANES. Information regarding cardiometabolic diseases, demographics, depressive symptoms, and sleep disorders were obtained. Logistic regression analyses were performed with group as the exposure and cardiometabolic diseases as the response. Adults with moderate ( = 550) and severe ( = 556) functional disabilities had a higher prevalence of cardiometabolic diseases, depressive symptoms, and sleep disorders compared to adults without functional disabilities ( = 3765; < 0.05). After adjusting for demographics, the odds of cardiovascular disease and diabetes were higher in adults with severe functional disabilities (OR: 1.47 and 1.76, < 0.05), but not in adults with moderate functional disabilities (OR: 1.21 and 1.22, > 0.05). With further adjustment for depressive symptoms and sleep disorders, the odds of cardiovascular disease (OR: 1.47) and diabetes (OR: 1.76) remained increased ( < 0.05) in adults with severe functional disabilities. By middle-age, adults with functional disabilities have an elevated prevalence of cardiometabolic diseases, depressive symptoms, and sleep disorders compared to adults without functional disabilities. The elevated cardiometabolic disease profiles are present in adults with severe functional disabilities even after adjusting depressive symptoms and sleep disorders.IMPLICATIONS FOR REHABILITATIONIn the elderly population, cardiometabolic diseases, depression, and sleep disorders are prevalent conditions and are often co-morbid.In a nationally representative sample of middle-aged adults, study findings found that those with severe functional disabilities had an elevated cardiometabolic disease prevalence compared to adults without functional disabilities, even after accounting for the higher prevalence of depressive symptoms and sleep disorders.Earlier screening for cardiometabolic diseases, depression, and sleep disorders in adults with functional disabilities, or those who are at risk for developing functional disabilities, are warranted.Interventions pertaining to physical, pharmacological, or care coordination focused on improving cardiometabolic disease profiles among adults with functional disabilities are needed.
本研究调查了抑郁症状和睡眠障碍是否改变了中年成年人（40 - 64岁）功能残疾与心脏代谢疾病谱之间的关联。参与者来自2007 - 2014年美国国家健康与营养检查调查（NHANES）。获取了有关心脏代谢疾病、人口统计学、抑郁症状和睡眠障碍的信息。以功能残疾分组作为暴露因素，心脏代谢疾病作为反应变量进行逻辑回归分析。与无功能残疾的成年人（n = 3765）相比，中度（n = 550）和重度（n = 556）功能残疾的成年人心脏代谢疾病、抑郁症状和睡眠障碍的患病率更高（P < 0.05）。在调整人口统计学因素后，重度功能残疾的成年人患心血管疾病和糖尿病的几率更高（比值比：1.47和1.76，P < 0.05），但中度功能残疾的成年人则不然（比值比：1.21和1.22，P > 0.05）。在进一步调整抑郁症状和睡眠障碍后，重度功能残疾的成年人患心血管疾病（比值比：1.47）和糖尿病（比值比：1.76）的几率仍然增加（P < 0.05）。到中年时，与无功能残疾的成年人相比，有功能残疾的成年人心脏代谢疾病、抑郁症状和睡眠障碍的患病率更高。即使在调整抑郁症状和睡眠障碍后，重度功能残疾的成年人心脏代谢疾病谱仍较高。
康复治疗的意义
在老年人群中，心脏代谢疾病、抑郁症和睡眠障碍是常见疾病，且往往合并存在。
在一个具有全国代表性的中年成年人样本中，研究结果发现，与无功能残疾的成年人相比，重度功能残疾的成年人心脏代谢疾病患病率更高，即使考虑到抑郁症状和睡眠障碍的患病率较高。
对于有功能残疾的成年人或有发展为功能残疾风险的成年人，有必要更早地筛查心脏代谢疾病、抑郁症和睡眠障碍。
需要针对身体、药物或护理协调方面进行干预，以改善有功能残疾的成年人的心脏代谢疾病谱。
