Tang Lars Hermann, Thygesen Lau Caspar, Willadsen Tora Grauers, Jepsen Randi, la Cour Karen, Frølich Anne, Møller Anne, Jørgensen Lars Bo, Skou Søren T
Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark.
Department of Regional Health Research, University of Southern Denmark, Denmark.
J Comorb. 2020 Dec 17;10:2235042X20981185. doi: 10.1177/2235042X20981185. eCollection 2020 Jan-Dec.
To investigate the association between clusters of conditions and psychological well-being across age groups.
This cross-sectional study used data collected in the Danish population-based Lolland-Falster Health Study. We included adults over the age of 18 years. Self-reported chronic conditions were divided into 10 groups of conditions. The primary outcome was psychological well-being (the WHO-5 Well-Being Index). Factor analysis constructed the clusters of conditions, and regression analysis investigated the association between clusters and psychological well-being.
Of 10,781 participants, 31.4% were between 18 and 49 years, 35.7% were between 50 and 64 years and 32.9% were above ≥65 years. 35.2% had conditions represented in 1 and 32.9% in at least 2 of 10 condition groups. Across age groups, living with one or more chronic conditions was associated with poorer psychological well-being. Two chronic condition patterns were identified; one comprised cardiovascular, endocrine, kidney, musculoskeletal and cancer conditions, the second mental, lung, neurological, gastrointestinal and sensory conditions. Both patterns were associated with poorer psychological well-being (Pattern 1: -4.5 (95% CI: -5.3 to -3.7), Pattern 2: -9.1 (95% CI -13.8 to -8.2). For pattern 2, participants ≥65 years had poorer psychological well-being compared to younger (-12.6 (95% CI -14.2 to -11.0) vs -6.6 (95% CI: -7.8 to -5.4) for 18-49 years and -8.7 (95% CI: -10.1 to -7.3) for 50-64 years, interaction: p ≤ 0.001).
Living with one or more chronic conditions is associated with poorer psychological well-being. Findings point toward a greater focus on supporting psychological well-being in older adults with both mental and somatic conditions.
探讨不同年龄组中疾病集群与心理健康之间的关联。
这项横断面研究使用了在丹麦基于人群的洛兰-法尔斯特健康研究中收集的数据。我们纳入了18岁以上的成年人。自我报告的慢性病被分为10组疾病。主要结局是心理健康(世界卫生组织-5幸福指数)。因子分析构建了疾病集群,回归分析研究了集群与心理健康之间的关联。
在10781名参与者中,31.4%在18至49岁之间,35.7%在50至64岁之间,32.9%在65岁及以上。35.2%的人患有1组疾病,32.9%的人至少患有10组疾病中的2组。在各个年龄组中,患有一种或多种慢性病与较差的心理健康相关。确定了两种慢性病模式;一种包括心血管、内分泌、肾脏、肌肉骨骼和癌症疾病,第二种包括精神、肺部、神经、胃肠道和感觉疾病。两种模式都与较差的心理健康相关(模式1:-4.5(95%置信区间:-5.3至-3.7),模式2:-9.1(95%置信区间-13.8至-8.2)。对于模式2,65岁及以上的参与者与较年轻的参与者相比心理健康较差(18至49岁为-12.6(95%置信区间-14.2至-11.0),50至64岁为-8.7(95%置信区间:-10.1至-7.3),交互作用:p≤0.001)。
患有一种或多种慢性病与较差的心理健康相关。研究结果表明,应更加关注支持患有精神和躯体疾病的老年人的心理健康。