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社区中老年居民的生活质量:功能比多种疾病更重要。

Quality of Life among Community-Dwelling Middle-Aged and Older Adults: Function Matters More than Multimorbidity.

机构信息

Institute of Management, Fo Guang University, Yi Lan, Taiwan.

Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan.

出版信息

Arch Gerontol Geriatr. 2021 Jul-Aug;95:104423. doi: 10.1016/j.archger.2021.104423. Epub 2021 Apr 21.

Abstract

OBJECTIVES

Quality of life stands for the comprehensive assessment for health conditions and the central concerns in the seniors' care. The inter-relationship between health-related quality of life (HRQoL) and multimorbidity among community-dwelling healthy older adults remains uncertain.

METHODS

Data of 1839 participants from the I-Lan Longitudinal Aging Study were excerpted for analysis. Functional status and HRQoL were measured by the Functional Autonomy Measurement System and the Chinese version of 12-item Short-Form Health Survey version 2. Poor HRQoL was defined as lowest quintile of physical and mental components summaries (PCS and MCS). Multivariable linear and logistic regression analysis were applied to explore associations between variables of interest.

RESULTS

Adjusted for potential confounders, multivariable linear regression showed that multimorbidity and functional impairment were negatively associated with PCS (β coefficients -1.8 vs. -8.4) and MCS (β coefficients -1.9 vs. -4.8). Logistic regression affirmed similar associations that the odds of being poor HRQoL were 1.6 (95% CI 1.1-2.2) for multimorbidity, and 5.4 (95% CI 2.8-10.3) for functional impairment in PCS; 1.9 (95% CI 1.4-2.6) for multimorbidity and 6.0 (95%CI 3.2-11.5) for functional impairment in MCS. Adjusted for depressive symptoms and cognitive performance, functional impairment was significantly associated with poor physical component (OR:4.68, 95% CI: 0.35-19.34, p<0.001) and mental component in HRQoL (OR:2.4, 95% CI: 1.1-5.5, p=0.032), but the associations were insignificant in multimorbidity.

CONCLUSIONS

Findings from the study strengthened the importance of functional performance on HRQoL among community-living middle-aged and older adults, which is essential in community health promotion activities and health service programs.

摘要

目的

生活质量代表对健康状况的全面评估以及老年人护理的核心关注点。在社区居住的健康老年人中,健康相关生活质量(HRQoL)与多种疾病之间的相互关系仍不确定。

方法

从宜兰纵向老龄化研究中摘录了 1839 名参与者的数据进行分析。功能状态和 HRQoL 分别使用功能自主性测量系统和中文版 12 项简短健康调查版本 2 进行测量。较差的 HRQoL 定义为身体成分综合得分和心理成分综合得分最低五分位数。采用多变量线性和逻辑回归分析来探讨感兴趣变量之间的关联。

结果

在调整潜在混杂因素后,多变量线性回归显示,多种疾病和功能障碍与 PCS(β系数-1.8 对-8.4)和 MCS(β系数-1.9 对-4.8)呈负相关。逻辑回归证实了类似的关联,即多种疾病发生较差 HRQoL 的几率为 1.6(95%CI 1.1-2.2),PCS 中功能障碍的几率为 5.4(95%CI 2.8-10.3);多种疾病发生较差 HRQoL 的几率为 1.9(95%CI 1.4-2.6),功能障碍的几率为 6.0(95%CI 3.2-11.5)。在调整抑郁症状和认知表现后,功能障碍与较差的生理成分(OR:4.68,95%CI:0.35-19.34,p<0.001)和 HRQoL 的心理成分(OR:2.4,95%CI:1.1-5.5,p=0.032)显著相关,但多种疾病的相关性不显著。

结论

研究结果强调了功能表现对社区中老年生活质量的重要性,这在社区健康促进活动和卫生服务计划中至关重要。

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