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挪威横断面 HUNT 研究中成年人多病共存伴衰弱的流行情况及其与社会经济地位的关系。

Prevalence of multimorbidity with frailty and associations with socioeconomic position in an adult population: findings from the cross-sectional HUNT Study in Norway.

机构信息

Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, NTNU, Trondheim, Norway

Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.

出版信息

BMJ Open. 2020 Jun 15;10(6):e035070. doi: 10.1136/bmjopen-2019-035070.

Abstract

OBJECTIVES

To explore prevalences and occupational group inequalities of two measures of multimorbidity with frailty.

DESIGN

Cross-sectional study.

SETTING

The Nord-Trøndelag Health Study (HUNT), Norway, a total county population health survey, 2006-2008.

PARTICIPANTS

Participants older than 25 years, with complete questionnaires, measurements and occupation data were included.

OUTCOMES

≥2 of 51 multimorbid conditions with ≥1 of 4 frailty measures (poor health, mental illness, physical impairment or social impairment) and ≥3 of 51 multimorbid conditions with ≥2 of 4 frailty measures.

ANALYSIS

Logistic regression models with age and occupational group were specified for each sex separately.

RESULTS

Of 41 193 adults, 38 027 (55% female; 25-100 years old) were included. Of them, 39% had ≥2 multimorbid conditions with ≥1 frailty measure, and 17% had ≥3 multimorbid conditions with ≥2 frailty measures. Prevalence differences in percentage points (pp) with 95% confidence intervals of those in high versus low occupational group with ≥2 multimorbid conditions and ≥1 frailty measure were largest in women age 30 years, 17 (14 to 20) pp and 55 years, 15 (13 to 17) pp and in men age 55 years, 15 (13 to 17) pp and 80 years, 14 (9 to 18) pp. In those with ≥3 multimorbid conditions and ≥2 frailty measures, prevalence differences were largest in women age 30 years, 8 (6 to 10) pp and 55 years, 10 (8 to 11) ppand in men age 55 years, 9 (8 to 11) pp and 80 years, 6 (95% CI 1 to 10) pp.

CONCLUSION

Multimorbidity with frailty is common, and social inequalities persist until age 80 years in women and throughout the lifespan in men. To manage complex multimorbidity, strategies for proportionate universalism in medical education, healthcare, public health prevention and promotion seem necessary.

摘要

目的

探讨与虚弱相关的两种多重疾病测量方法的流行率和职业群体差异。

设计

横断面研究。

地点

挪威特隆赫姆郡健康研究(HUNT),一个全县人口健康调查,2006-2008 年。

参与者

纳入年龄大于 25 岁、完成问卷、测量和职业数据的参与者。

结果

≥51 种多种疾病中的 2 种与≥4 种虚弱测量中的 1 种(健康状况不佳、精神疾病、身体损伤或社会功能障碍),≥51 种多种疾病中的 3 种与≥4 种虚弱测量中的 2 种。

分析

为每个性别分别指定了包含年龄和职业群体的逻辑回归模型。

结果

在 41193 名成年人中,纳入 38027 名(55%为女性;年龄 25-100 岁)。其中,39%的人患有≥2 种多种疾病和≥1 种虚弱测量,17%的人患有≥3 种多种疾病和≥2 种虚弱测量。在≥2 种多种疾病和≥1 种虚弱测量的情况下,高职业组与低职业组之间的百分比差异(pp)差异最大,女性年龄在 30 岁时为 17(14 至 20)pp,55 岁时为 15(13 至 17)pp,男性年龄在 55 岁时为 15(13 至 17)pp,80 岁时为 14(9 至 18)pp。在患有≥3 种多种疾病和≥2 种虚弱测量的患者中,女性年龄在 30 岁时,差异最大,为 8(6 至 10)pp,55 岁时为 10(8 至 11)pp,男性年龄在 55 岁时,差异最大,为 9(8 至 11)pp,80 岁时为 6(95%CI 1 至 10)pp。

结论

与虚弱相关的多种疾病很常见,社会不平等现象持续存在,直到女性 80 岁,男性终生。为了管理复杂的多种疾病,在医学教育、医疗保健、公共卫生预防和促进方面,需要采取比例普遍主义的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7ca/7299023/f09d81b782d8/bmjopen-2019-035070f01.jpg

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