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80 岁以上老年人的多病共存、衰弱和功能障碍:关系的结构方程分析。

Multimorbidity, frailty and functional disability in octogenarians: A structural equation analysis of relationship.

机构信息

Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.

Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.

出版信息

Arch Gerontol Geriatr. 2020 Jan-Feb;86:103931. doi: 10.1016/j.archger.2019.103931. Epub 2019 Aug 2.

Abstract

Path analysis allows for an understanding of the complex interrelationships between multiple variables and interactions in the octogenarians. The aim of this study was to estimate the isolated and combined prevalence of multimorbidity, frailty and functional disability and the direct and indirect association of these conditions in octogenarians. A cross-sectional study was conducted with 166 community-dwelling individuals aged 80 years or older participating in the FIBRA80+ epidemiological study. Multimorbidity was defined by three or more chronic diseases, frailty according to 3 or more components of physical frailty phenotype and functional disability as aid needed to perform one or more activities of daily living (ADLs). Associations were tested by Pearson's chi-square test; the relationship between the variables of interest and the mediating variables was tested with structural equation (path) analysis. We observed a higher prevalence of seniors with disability and multimordibity/disability. In path analysis, number of chronic diseases mediated the relation between sex and number of frailty components (p = 0.031), and these mediated the relation between number of diseases and disability (p = 0.008). The study points out the relationship between the simultaneous presence and interaction between multimorbidity, functional disability and frailty. Through path analysis, our findings provide characteristics in relation to the health-disease process, mainly mediation and interaction among octogenarians.

摘要

路径分析可以理解 80 岁以上人群中多个变量之间的复杂相互关系和相互作用。本研究旨在估计 80 岁以上人群中多种疾病、虚弱和功能障碍的单独和联合患病率,以及这些疾病的直接和间接关联。本横断面研究纳入了参加 FIBRA80+ 流行病学研究的 166 名 80 岁及以上的社区居民。采用三种或三种以上慢性疾病定义多种疾病,采用三种或三种以上身体虚弱表型的组成部分定义虚弱,采用需要一种或多种日常生活活动(ADL)辅助来定义功能障碍。采用 Pearson 卡方检验检验关联;采用结构方程(路径)分析检验感兴趣变量和中介变量之间的关系。我们观察到残疾和多种疾病/残疾的老年人比例较高。在路径分析中,慢性疾病数量介导了性别与虚弱组成部分数量之间的关系(p=0.031),这些因素介导了疾病数量与残疾之间的关系(p=0.008)。该研究指出了同时存在多种疾病、功能障碍和虚弱以及它们之间相互作用的关系。通过路径分析,我们的发现提供了与 80 岁以上人群健康疾病过程相关的特征,主要是中介和相互作用。

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