College of Nursing, Pusan National University, Gyeongsangnam-do 50612, Korea.
School of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA.
Int J Environ Res Public Health. 2021 Feb 11;18(4):1745. doi: 10.3390/ijerph18041745.
Older adults suffer from multiple symptoms, which negatively affects their health-related quality of life. The single-symptom management approach has been less than effective. The data of 2362 Korean community-dwelling older adults aged 70 and above were analyzed in the Korean Frailty and Aging Cohort Study (KFACS) study. A cluster analysis, correlation analysis, and logistic regression were used to analyze the data. We found three symptom clusters: high symptom burden (HSB, = 1032); pain and fatigue group (PAF, = 566); and the sleep deprivation group (SDP, = 764). Participants in the HSB group are more likely to be of old age (OR = 1.1), be female (OR = 2.4), live in a rural area (OR = 1.4), have low physical activity (OR = 0.9), and have multiple chronic conditions (OR = 1.5). The clinical blood markers analysis showed a negative relationship among the physical health, free T4 ( = -0.083, < 0.01) and insulin ( = -0.084, < 0.01). The sex-specific blood markers analysis showed differences among three clusters. While free testosterone (male: = 0.124, female: = 0.110, < 0.05) and dehydroepiandrosterone (DHEA) (male: = 0.352 and female: = 0.134, < 0.05) were associated with physical health in the HSB group, only free testosterone was associated with mental health (male: = -0.093, and female: = -0.116, < 0.05) in the SDP group. These findings suggest the potential role of the patient's sex and sex hormones in symptoms of Korean community-dwelling older adults. Understanding the symptom profiles and impact of biopsychosocial factors may enhance precision symptom management.
老年人患有多种症状,这对他们的健康相关生活质量产生负面影响。单一症状管理方法效果不佳。本研究对参加韩国衰弱和老龄化队列研究(KFACS)的 2362 名 70 岁及以上的韩国社区居住老年人的数据进行了分析。采用聚类分析、相关分析和逻辑回归对数据进行了分析。我们发现了三个症状群:高症状负担(HSB,n=1032)、疼痛和疲劳组(PAF,n=566)和睡眠剥夺组(SDP,n=764)。HSB 组的参与者更有可能年龄较大(OR=1.1)、女性(OR=2.4)、居住在农村地区(OR=1.4)、身体活动较少(OR=0.9)和患有多种慢性病(OR=1.5)。临床血液标志物分析显示,生理健康与游离 T4(=-0.083,<0.01)和胰岛素(=-0.084,<0.01)呈负相关。性别特异性血液标志物分析显示,三个症状群之间存在差异。游离睾酮(男性:=0.124,女性:=0.110,<0.05)和脱氢表雄酮(DHEA)(男性:=0.352,女性:=0.134,<0.05)与 HSB 组的生理健康相关,而只有游离睾酮与 SDP 组的心理健康相关(男性:=-0.093,女性:=-0.116,<0.05)。这些发现表明患者的性别和性激素在韩国社区居住的老年人的症状中可能发挥作用。了解症状特征和生物心理社会因素的影响可能会增强精准症状管理。