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中年人及老年人多病共存的流行率、相关因素和结局:来自中国健康与养老追踪调查的发现。

Prevalence, correlates and outcomes of multimorbidity among the middle-aged and elderly: Findings from the China Health and Retirement Longitudinal Study.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China.

Liyang Center for Disease Control and Prevention, 55 Nanhuan Road, Liyang 213371, PR China.

出版信息

Arch Gerontol Geriatr. 2020 Sep-Oct;90:104135. doi: 10.1016/j.archger.2020.104135. Epub 2020 Jun 4.

Abstract

BACKGROUND

The multimorbidity associated with ageing has been prevalent worldwide and poses major challenges to the health care system. However, the research about multimorbidity in China is far from sufficient. Additionally, international studies on the influencing factors of multimorbidity and the impact on disability/mortality are still inconsistent. The aim of this study was to examine the prevalence, correlates and outcomes of multimorbidity among the middle-aged and elderly Chinese population.

METHODS

We used data from the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression was performed to analyze the influencing factors of multimorbidity. The Cox proportional hazard model was used to evaluate the impact of multimorbidity on functional disability and all-cause mortality.

RESULTS

The prevalence of multimorbidity was 55.12 % in the whole study population and 65.60 % among people aged ≥ 65 years. Multimorbidity was significantly associated with old age (OR: 2.76, 95 % CI: 2.31-3.30), females (OR: 1.21, 95 % CI: 1.01-1.44), ex-smoker (OR: 2.07, 95 % CI: 1.58-2.72), ex-drinker (OR: 2.18, 95 % CI: 1.66-2.87), obesity (OR: 2.87, 95 % CI: 2.30-3.57), lower education (OR:1.32, 95 % CI: 1.08-1.61), living alone (OR: 1.26, 95 % CI: 1.02-1.55) and unemployment (OR: 1.66, 95 % CI: 1.11-2.48). Moreover, multimorbidity was correlated with disability (HR: 2.27, 95 % CI: 1.93-2.66) and all-cause mortality (HR: 1.95, 95 % CI: 1.36-2.80) after multivariable adjustment.

CONCLUSIONS

Multimorbidity is highly prevalent in China and possesses significantly negative effects on health outcomes. Identification of the key population and tailored interventions on their modifiable risk factors should be paid much importance.

摘要

背景

与老龄化相关的多种疾病在全球普遍存在,给医疗保健系统带来了重大挑战。然而,中国关于多种疾病的研究还远远不够。此外,关于多种疾病的影响因素及其对残疾/死亡率影响的国际研究仍然不一致。本研究旨在调查中国中老年人群中多种疾病的患病率、相关因素和结局。

方法

我们使用了中国健康与养老追踪调查(CHARLS)的数据。采用 logistic 回归分析多种疾病的影响因素。采用 Cox 比例风险模型评估多种疾病对功能残疾和全因死亡率的影响。

结果

在整个研究人群中,多种疾病的患病率为 55.12%,≥65 岁人群中为 65.60%。多种疾病与年龄较大(OR:2.76,95%CI:2.31-3.30)、女性(OR:1.21,95%CI:1.01-1.44)、曾经吸烟者(OR:2.07,95%CI:1.58-2.72)、曾经饮酒者(OR:2.18,95%CI:1.66-2.87)、肥胖(OR:2.87,95%CI:2.30-3.57)、受教育程度较低(OR:1.32,95%CI:1.08-1.61)、独居(OR:1.26,95%CI:1.02-1.55)和失业(OR:1.66,95%CI:1.11-2.48)显著相关。此外,多变量调整后,多种疾病与残疾(HR:2.27,95%CI:1.93-2.66)和全因死亡率(HR:1.95,95%CI:1.36-2.80)相关。

结论

多种疾病在中国高度流行,对健康结果有显著的负面影响。应重视识别关键人群,并针对其可改变的危险因素进行有针对性的干预。

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