Guo Xiaorong, Zhao Benhua, Chen Tianmu, Hao Bin, Yang Tao, Xu Huimin
Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, School of Public Health, Xiamen University, Xiamen, Fujian, China.
PLoS One. 2021 Aug 5;16(8):e0255908. doi: 10.1371/journal.pone.0255908. eCollection 2021.
This study aimed to investigate the spatial distribution and patterns of multimorbidity among the elderly in China. Data on the occurrence of 14 chronic diseases were collected for 9710 elderly participants in the 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Web graph, Apriori algorithm, age-adjusted Charlson comorbidity index (AAC), and Spatial autocorrelation were used to perform the multimorbidity analysis. The multimorbidity prevalence rate was estimated as 49.64% in the elderly in China. Three major multimorbidity patterns were identified: [Asthma/Chronic lungs diseases]: (Support (S) = 6.17%, Confidence (C) = 63.77%, Lift (L) = 5.15); [Asthma, Arthritis, or rheumatism/ Chronic lungs diseases]: (S = 3.12%, C = 64.03%, L = 5.17); [Dyslipidemia, Hypertension, Arthritis or rheumatism/Heart attack]: (S = 3.96%, C = 51.56, L = 2.69). Results of the AAC analysis showed that the more chronic diseases an elderly has, the lower is the 10-year survival rate (P < 0.001). Global spatial autocorrelation showed a positive spatial correlation distribution for the prevalence of the third multimorbidity pattern in China (P = 0.032). The status of chronic diseases and multimorbidity among the elderly with a spatial correlation is a significant health issue in China.
本研究旨在调查中国老年人中多种慢性病共存的空间分布及模式。在中国健康与养老追踪调查(CHARLS)2015年的数据中,收集了9710名老年参与者14种慢性病的发病情况。采用网络图、Apriori算法、年龄调整的查尔森合并症指数(AAC)和空间自相关分析多种慢性病共存情况。中国老年人多种慢性病共存患病率估计为49.64%。确定了三种主要的多种慢性病共存模式:[哮喘/慢性肺部疾病]:(支持度(S)=6.17%,置信度(C)=63.77%,提升度(L)=5.15);[哮喘、关节炎或风湿病/慢性肺部疾病]:(S=3.12%,C=64.03%,L=5.17);[血脂异常、高血压、关节炎或风湿病/心脏病发作]:(S=3.96%,C=51.56,L=2.69)。AAC分析结果显示,老年人患慢性病越多,10年生存率越低(P<0.001)。全局空间自相关分析显示,中国第三种多种慢性病共存模式的患病率呈正空间相关分布(P=0.032)。具有空间相关性的老年人慢性病及多种慢性病共存状况是中国一个重要的健康问题。