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欧洲老年人的多种共病模式及其相关特征:纵向视角。

Multimorbidity patterns and their related characteristics in European older adults: A longitudinal perspective.

机构信息

Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain.

Research Group on Aging, Disability and Health, Girona Biomedical Research Institute (IDIBGI), Catalonia, Spain.

出版信息

Arch Gerontol Geriatr. 2021 Jul-Aug;95:104428. doi: 10.1016/j.archger.2021.104428. Epub 2021 May 4.

Abstract

BACKGROUND

The concurrence of several chronic conditions is a rising concern that poses a serious burden on ageing populations. Analysing how these conditions appear together and how they change through time may provide useful information to design successful multimorbidity-management programs.

OBJECTIVE

To identify multimorbidity patterns and their related characteristics from a longitudinal perspective.

SUBJECTS

25,931 older adults aged 50+ drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), a population-based longitudinal European study.

METHODS

A sex-stratified Latent Transition Analysis was conducted to fit latent classes based on 15 self-reported chronic conditions across three time points. Health-related and socioeconomic variables were assessed as covariates of those patterns.

RESULTS

We identified 4 time-constant latent classes for each sex. A "severely impaired" class (with a weighted prevalence percentage of 7.24% for females and 3.30% for males at the first time point), a "metabolic" class (26.15% and 23.82%) and a "healthy" class (50.92% and 54.32%). The fourth class was named "osteoarticular" for females (15.70%) and "articular-COPD-ulcer" for males (18.56%). Age, smoke, material deprivation and a high body mass index were associated with worse health patterns, whereas education, being employed and physical activity were related to less multimorbid classes. Few class changes were detected when modelling transitions.

CONCLUSIONS

We reported information of multimorbidity classes and their characteristics that may help to develop targeted health strategies. Within a time window of four years, the identified latent classes were consistent between time points.

摘要

背景

多种慢性疾病同时存在是一个日益严重的问题,给老龄化人口带来了严重负担。分析这些疾病如何同时出现以及它们如何随时间变化,可能为设计成功的多病种管理计划提供有用信息。

目的

从纵向角度确定多病种模式及其相关特征。

受试者

来自欧洲基于人群的纵向研究“健康、衰老和退休研究”(SHARE)的 25931 名 50 岁及以上的老年人。

方法

对 15 种自我报告的慢性疾病在三个时间点进行了性别分层潜在转变分析,以基于这些疾病拟合潜在类别。健康相关和社会经济变量被评估为这些模式的协变量。

结果

我们为每个性别确定了 4 个时间不变的潜在类别。一个“严重受损”类别(在第一个时间点女性的加权患病率百分比为 7.24%,男性为 3.30%),一个“代谢”类别(26.15%和 23.82%)和一个“健康”类别(50.92%和 54.32%)。第四个类别女性命名为“骨关节炎”(15.70%),男性命名为“关节 COPD 溃疡”(18.56%)。年龄、吸烟、物质匮乏和高身体质量指数与较差的健康模式相关,而教育、就业和体育活动与较少的多病种类别相关。在建模转换时,检测到的类别变化很少。

结论

我们报告了多病种类别的信息及其特征,这可能有助于制定有针对性的健康策略。在四年的时间窗口内,确定的潜在类别在时间点之间保持一致。

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