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基于慢性疾病数量的多病种分组与日常活动有关。

Multimorbidity groups based on numbers of chronic conditions are associated with daily activity.

机构信息

National Rehabilitation Research and Training Center on Family Support, Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, USA.

Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Chronic Illn. 2022 Sep;18(3):634-642. doi: 10.1177/17423953211023964. Epub 2021 Jun 23.

Abstract

OBJECTIVE

Instrumental activities of daily living (IADL) are important for managing multiple chronic conditions (MCC) and maintaining independence while aging. Using data from the National Health and Aging Trends Study (NHATS), we answered the question: are there differences in ability and performance of IADL among groups of older adults with 0-1 (no MCC), 2-4 (low MCC), and 5+ chronic conditions (multisystem morbidity: MM)?

METHODS

Cross-sectional study using Poisson regression and incidence rate ratios. Participants were 6,019 community-dwelling older adults who regularly take medications. We derived composite variables for ability and performance of IADL; MCC groups were based on count of 11 chronic conditions.

RESULTS

Older adults with MM had lower IADL count for ability (IRR = .81) and performance (IRR = .77), and MM group significantly predicted both ability and performance of IADL (p < .001); 'low MCC' group was not significantly different than 'no MCC' regarding disability.

DISCUSSION

Having MM is statistically and clinically different than having low MCC or no MCC; 5+ chronic conditions may be a meaningful inclusion criterion for interventions to decrease disability and 2-4 chronic conditions may be better for trials to prevent disability. Researchers should measure both ability and performance of daily activity.

摘要

目的

工具性日常生活活动(IADL)对于管理多种慢性疾病(MCC)和在老龄化过程中保持独立性非常重要。利用来自国家健康老龄化趋势研究(NHATS)的数据,我们回答了一个问题:在患有 0-1 种(无 MCC)、2-4 种(低 MCC)和 5+种慢性疾病(多系统发病:MM)的老年人群体中,IADL 的能力和表现是否存在差异?

方法

使用泊松回归和发病率比的横断面研究。参与者为 6019 名经常服用药物的居住在社区的老年人。我们得出了 IADL 能力和表现的综合变量;MCC 组基于 11 种慢性疾病的计数。

结果

患有 MM 的老年人的 IADL 能力(IRR = .81)和表现(IRR = .77)较低,且 MM 组显著预测了 IADL 的能力和表现(p < .001);“低 MCC”组在残疾方面与“无 MCC”组无显著差异。

讨论

患有 MM 在统计学和临床上与患有低 MCC 或无 MCC 不同;5+种慢性疾病可能是减少残疾的干预措施的一个有意义的纳入标准,而 2-4 种慢性疾病可能更适合预防残疾的试验。研究人员应同时测量日常活动的能力和表现。

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