Clerencia-Sierra Mercedes, Ioakeim-Skoufa Ignatios, Poblador-Plou Beatriz, González-Rubio Francisca, Aza-Pascual-Salcedo Mercedes, Gimeno-Miguel Mónica Machón Antonio, Prados-Torres Alexandra
Aragon Health Service (SALUD); EpiChron Research Group, 50009 Zaragoza, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 28222 Madrid, Spain.
J Clin Med. 2020 May 21;9(5):1563. doi: 10.3390/jcm9051563.
This study aims to describe the clinical course, drug use, and health services use characteristics during the last year of life of elders who die being centenarians and to identify key aspects differentiating them from elders who die at an earlier age, with a particular focus on sex differences. We conducted an observational, population-based study in the EpiChron Cohort (Aragón, Spain). The population was stratified by sex and into three age sub-populations (80-89, 90-99, and ≥100 years), and their characteristics were described and compared. Multimorbidity was the rule in our elders, affecting up to 3 in 4 centenarians and 9 in 10 octogenarians and nonagenarians. Polypharmacy was also observed in half of the centenarian population and in most of the younger elders. Risk factors for cardiovascular disease (i.e., hypertension, dyslipidaemia, diabetes), cerebrovascular disease and dementia were amongst the most common chronic conditions in all age groups, whereas the gastroprotective drugs and antithrombotic agents were the most dispensed drugs. Centenarians presented in general lower morbidity and treatment burden and lower use of both primary and hospital healthcare services than octogenarians and nonagenarians, suggesting a better health status. Sex-differences in their clinical characteristics were more striking in octogenarians and tended to decrease with age.
本研究旨在描述百岁老人临终前一年的临床病程、药物使用及医疗服务利用特征，并找出将他们与早逝老人区分开来的关键因素，特别关注性别差异。我们在EpiChron队列（西班牙阿拉贡）中开展了一项基于人群的观察性研究。将人群按性别和三个年龄亚组（80 - 89岁、90 - 99岁和≥100岁）进行分层，并对其特征进行描述和比较。多重疾病在我们的老年人群中很常见，四分之三的百岁老人、十分之九的八旬老人和九旬老人都受其影响。半数百岁老人及大多数较年轻老人中也存在多重用药情况。心血管疾病（即高血压、血脂异常、糖尿病）、脑血管疾病和痴呆症的危险因素是所有年龄组中最常见的慢性病，而胃保护药物和抗血栓药物是最常配发的药物。总体而言，百岁老人比八旬老人和九旬老人的发病率和治疗负担更低，初级和医院医疗服务的使用也更少，这表明他们的健康状况更好。八旬老人临床特征的性别差异更为显著，且往往随年龄增长而减小。
