Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Department of Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy.
Am J Epidemiol. 2019 Sep 1;188(9):1627-1636. doi: 10.1093/aje/kwz101.
Rapidly accumulating multiple chronic conditions (multimorbidity) during aging are associated with many adverse outcomes. We explored the association between 4 experiences throughout life-childhood socioeconomic circumstances, early-adulthood education, midlife occupational stress, and late-life social network-and the speed of chronic disease accumulation. We followed 2,589 individuals aged ≥60 years from the Swedish National Study on Aging and Care in Kungsholmen for 9 years (2001-2013). Information on life experiences was collected from detailed life-history interviews. Speed of disease accumulation was operationalized as the change in the count of chronic conditions obtained from clinical examinations, medical histories, laboratory data, drug use, and register linkages over 9 years. Linear mixed models were used to analyze the data. Speed of disease accumulation was lower in individuals with more than elementary education (for secondary, β × time = -0.065, 95% CI: -0.126, -0.004; for university, β × time = -0.118, 95% CI: -0.185, -0.050); for active occupations compared with high-strain jobs (β × time = -0.078, 95% CI: -0.138, -0.017); and for richer social networks (for moderate tertile, β × time = -0.102, 95% CI: -0.149, -0.055; for highest tertile, β × time = -0.135, 95% CI: -0.182, -0.088). The association between childhood circumstances and speed of disease accumulation was attenuated by later-life experiences. Diverse experiences throughout life might decelerate chronic disease accumulation during aging.
随着年龄的增长,多种慢性疾病(多病共存)迅速积累与许多不良后果相关。我们探讨了一生中的 4 种经历(儿童期社会经济状况、成年早期教育、中年职业压力和晚年社交网络)与慢性疾病积累速度之间的关系。我们对 2589 名年龄在 60 岁及以上的瑞典 Kungsholmen 老龄化与护理研究的参与者进行了为期 9 年的随访(2001-2013 年)。生活经历的信息是通过详细的生活史访谈收集的。疾病积累速度的计算方法是通过临床检查、病史、实验室数据、药物使用和登记链接在 9 年内获得的慢性疾病数量的变化来衡量的。使用线性混合模型分析数据。接受过高于基本教育的个体(接受中等教育,β×时间=-0.065,95%CI:-0.126,-0.004;接受大学教育,β×时间=-0.118,95%CI:-0.185,-0.050)、从事积极职业(β×时间=-0.078,95%CI:-0.138,-0.017)和拥有更丰富社交网络(中等三分位,β×时间=-0.102,95%CI:-0.149,-0.055;最高三分位,β×时间=-0.135,95%CI:-0.182,-0.088)的个体,其疾病积累速度较低。晚年的经历削弱了儿童时期环境与疾病积累速度之间的关系。一生中的各种经历可能会减缓衰老过程中慢性疾病的积累。