Department of Family Medicine, Aminu Kano Teaching Hospital, Kano State, Nigeria.
West Afr J Med. 2021 Jul 29;38(7):620-628.
Globally, multimorbidity has attracted considerable attention in recent years. In resource-poor settings, the elderly bears the highest burden of chronic illnesses. Poor outcomes associated with multimorbidity in the elderly are well reported. However, the relationship between multimorbidity and functional status in elderly patients in developing countries is poorly understood.
To examine the burden of multimorbidity and functional disability as well as the factors associated with multimorbidity among the elderly in a primary care setting in Kano.
This was a cross-sectional study of 279 elderly patients randomly selected among the General Outpatient Clinic attendees of a Nigerian tertiary hospital. Data on participants' socio-demographics and diagnoses were collected. The Katz activity of daily living index was used to assess functional status. Data were analysed using SPSS and odds ratios were calculated.
Participants were predominantly females (66.7%). The prevalence of multimorbidity and functional disability were 72.0% and 16.9%, respectively. Functional disability was found to have a positive interplay with multimorbidity (OR=20.819, 95%CI=1.752-247.4 and p=0.016). Other predictors of multimorbidity were lack of formal education (OR=0.362, 95%CI=0.141-0.931, p=0.035), unemployment (OR=0.386, 95%CI=0.165-0.903, p=0.028), and increased Body Mass Index (OR=218.8, 95%CI=12.090-3961.8 p<0.001).
The burden of multimorbidity and functional disability is high. The predictors in this study could be valuable in identifying the elderly with greater risk of becoming multimorbid in similar primary care settings.
近年来，全球范围内，多种疾病共存（multimorbidity）引起了广泛关注。在资源匮乏的环境下，慢性病的负担主要落在老年人身上。老年人多种疾病共存会导致较差的预后，这一点已得到充分证实。然而，发展中国家的老年患者多种疾病共存与功能状态之间的关系尚不清楚。
在尼日利亚一家三级医院的普通门诊就诊者中，调查初级保健环境下老年人的多种疾病共存负担和功能障碍，并分析其相关因素。
这是一项横断面研究，对尼日利亚一家三级医院普通门诊的 279 名老年患者进行了随机抽样。收集了参与者的社会人口统计学和诊断数据。使用 Katz 日常生活活动指数评估功能状态。使用 SPSS 进行数据分析，并计算了比值比。
参与者主要为女性（66.7%）。多种疾病共存和功能障碍的患病率分别为 72.0%和 16.9%。功能障碍与多种疾病共存呈正相关（比值比=20.819，95%置信区间=1.752-247.4，p=0.016）。多种疾病共存的其他预测因素包括缺乏正规教育（比值比=0.362，95%置信区间=0.141-0.931，p=0.035）、失业（比值比=0.386，95%置信区间=0.165-0.903，p=0.028）和体重指数增加（比值比=218.8，95%置信区间=12.090-3961.8，p<0.001）。
多种疾病共存和功能障碍的负担较高。本研究中的预测因素对于在类似的初级保健环境中识别出更容易发生多种疾病共存的老年人可能具有重要价值。
