利用潜在类别分析识别 50 岁及以上韩国成年人的多种共病模式及其相关因素。
Use of latent class analysis to identify multimorbidity patterns and associated factors in Korean adults aged 50 years and older.
机构信息
Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
National Cancer Control Institute, National Cancer Center, Goyang, Korea.
出版信息
PLoS One. 2019 Nov 13;14(11):e0216259. doi: 10.1371/journal.pone.0216259. eCollection 2019.
INTRODUCTION
Multimorbidity associated with significant disease and economic burdens is common among the aged. We identified chronic disease multimorbidity patterns in Koreans 50 years of age or older, and explored whether such patterns were associated with particular sociodemographic factors and health-related quality-of-life.
METHODS
The multimorbidity patterns of 10 chronic diseases (hypertension, dyslipidemia, stroke, osteoarthritis, tuberculosis, asthma, allergic rhinitis, depression, diabetes mellitus, and thyroid disease) were identified via latent class analysis of data on 8,370 Korean adults aged 50+ years who participated in the sixth Korean National Health and Nutrition Examination Survey (2013-2015). The associations between multimorbidity patterns, and sociodemographic factors and health-related quality of life, were subjected to regression analysis.
RESULTS
Three patterns of multimorbidity were identified: 1) a relatively healthy group (60.4% of the population); 2) a 'cardiometabolic conditions' group (27.8%); and, 3) an 'arthritis, asthma, allergic rhinitis, depression, and thyroid disease' group (11.8%). The female (compared to male) gender was associated with an increased likelihood of membership of the cardiometabolic conditions group (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.15-1.51) and (to a much greater extent) the arthritis, asthma, allergy, depression, and thyroid disease group (OR = 4.32, 95% CI = 3.30-5.66). Low socioeconomic status was associated with membership of the two multimorbidity classes. Membership of the arthritis, asthma, allergy, depression, and thyroid disease group was associated with a significantly poorer health-related quality-of-life than was membership of the other two groups.
CONCLUSION
The co-occurrence of chronic diseases was not attributable to chance. Multimorbidity patterns were associated with sociodemographic factors and quality-of-life. Our results suggest that targeted, integrated public health and clinical strategies dealing with chronic diseases should be based on an understanding of multimorbidity patterns; this would improve the quality-of-life of vulnerable multimorbid adults.
简介
与重大疾病和经济负担相关的多种合并症在老年人中很常见。我们确定了 50 岁及以上韩国人慢性疾病的多种合并症模式，并探讨了这些模式是否与特定的社会人口因素和健康相关的生活质量有关。
方法
通过对参加第六届韩国国家健康和营养检查调查（2013-2015 年）的 8370 名 50 岁及以上韩国成年人的 10 种慢性疾病（高血压、血脂异常、中风、骨关节炎、结核病、哮喘、过敏性鼻炎、抑郁症、糖尿病和甲状腺疾病）的数据进行潜在类别分析，确定了多种合并症模式。使用回归分析探讨多种合并症模式与社会人口因素和健康相关生活质量之间的关联。
结果
确定了三种多种合并症模式：1）相对健康组（占总人口的 60.4%）；2）“心脏代谢疾病”组（27.8%）；3）“关节炎、哮喘、过敏性鼻炎、抑郁症和甲状腺疾病”组（11.8%）。与男性相比，女性（与男性相比）更有可能属于心脏代谢疾病组（优势比 [OR] = 1.32，95%置信区间 [CI] = 1.15-1.51）和（在更大程度上）属于关节炎、哮喘、过敏、抑郁症和甲状腺疾病组（OR = 4.32，95% CI = 3.30-5.66）。低社会经济地位与两种多种合并症类别有关。属于关节炎、哮喘、过敏、抑郁症和甲状腺疾病组的人，其健康相关生活质量明显差于属于其他两组的人。
结论
慢性疾病的同时发生不是偶然的。多种合并症模式与社会人口因素和生活质量有关。我们的研究结果表明，有针对性的、综合的公共卫生和临床策略应基于对多种合并症模式的理解，以治疗慢性疾病；这将提高弱势多种合并症成年人的生活质量。
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