Center for General Medicine Education, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Department of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
BMJ Open. 2022 Feb 24;12(2):e049262. doi: 10.1136/bmjopen-2021-049262.
This study aimed to identify associations between multimorbidity and subjective health outcomes among the very old persons, after adjusting for coexisting conditions such as frailty and depression.
This was an observational cross-sectional study involving 1012 independent, community-dwelling very old persons (507 men, 505 women; aged 85-89 years) in Kawasaki city, Japan.
The primary outcome was the cross-sectional associations between multimorbidity and poor self-rated health (SRH) and life satisfaction using binary logistic regression. The secondary outcome was the association of subjective health with each chronic condition.
The prevalence of multimorbidity (≥2 conditions) was 94.7%, and the average number of chronic conditions was 4.47±1.9. Multimorbidity was significantly associated with poor SRH in the adjusted model only when six or more chronic conditions were present (OR 4.80; 95% CI 1.34 to 17.11; p=0.016). Cerebrovascular disease, heart disease, respiratory disease, connective tissue disease and arthritis showed significant associations with poor SRH after multivariate adjustment. Sex-specific analysis replicated associations between multimorbidity with six or more conditions and SRH in both men and women, while the diseases with the greatest impact on SRH differed between men and women. Most conditions were not associated with low satisfaction with life scale, with the exception of arthritis (OR 1.92, 95% CI 1.32 to 2.78, p=0.001).
Multimorbidity is prevalent in the independent, community-dwelling very old persons and is associated with poor SRH when six or more conditions are present; conditions causing mobility limitations, such as cerebrovascular disease, connective tissue disease and arthritis, have a negative impact on SRH.
UMIN000026053.
本研究旨在调整衰弱和抑郁等共存疾病后，确定多病共存与非常老年人主观健康结果之间的关联。
这是一项观察性横断面研究，涉及日本川崎市的 1012 名独立的、居住在社区的非常老年人（507 名男性，505 名女性；年龄 85-89 岁）。
主要结果是使用二元逻辑回归分析多病共存与较差的自我报告健康（SRH）和生活满意度之间的横断面关联。次要结果是主观健康与每种慢性疾病的关联。
多病共存（≥2 种疾病）的患病率为 94.7%，平均慢性疾病数为 4.47±1.9。仅当存在六种或更多种慢性疾病时，多病共存与较差的 SRH 在调整后的模型中具有显著相关性（OR 4.80；95%CI 1.34 至 17.11；p=0.016）。脑血管疾病、心脏病、呼吸系统疾病、结缔组织疾病和关节炎在多变量调整后与较差的 SRH 显著相关。男女两性的性别特异性分析均复制了与多病共存与六种或更多种疾病与 SRH 之间的关联，而对 SRH 影响最大的疾病在男女两性之间存在差异。除关节炎（OR 1.92，95%CI 1.32 至 2.78，p=0.001）外，大多数疾病与对生活满意度量表的低评分无关。
在独立的、居住在社区的非常老年人中，多病共存很常见，当存在六种或更多种疾病时，与较差的 SRH 相关；导致行动受限的疾病，如脑血管疾病、结缔组织疾病和关节炎，对 SRH 有负面影响。
UMIN000026053。
