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丹麦洛兰-法尔斯特健康研究中年轻人和老年人慢性病集群与心理健康之间的关联——一项基于人群的横断面研究

The association between clusters of chronic conditions and psychological well-being in younger and older people-A cross-sectional, population-based study from the Lolland-Falster Health Study, Denmark.

作者信息

Tang Lars Hermann, Thygesen Lau Caspar, Willadsen Tora Grauers, Jepsen Randi, la Cour Karen, Frølich Anne, Møller Anne, Jørgensen Lars Bo, Skou Søren T

机构信息

Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark.

Department of Regional Health Research, University of Southern Denmark, Denmark.

出版信息

J Comorb. 2020 Dec 17;10:2235042X20981185. doi: 10.1177/2235042X20981185. eCollection 2020 Jan-Dec.

Abstract

AIM

To investigate the association between clusters of conditions and psychological well-being across age groups.

METHOD

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

探讨不同年龄组中疾病集群与心理健康之间的关联。

方法

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。

结果

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)。

结论

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。

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