Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wrocław, Poland.
Harvard Division of Continuing Education, Harvard University, Cambridge, MA 02138-3722, USA.
Int J Environ Res Public Health. 2022 Mar 15;19(6):3461. doi: 10.3390/ijerph19063461.
Background: Multimorbidity is a common problem worldwide. It carries the risk of reduced quality of life, disability, frequent hospitalizations, and death. The present study was designed to assess the relationships that exist between multimorbidity and disability in elderly patients. Methods: The study included 100 patients and was conducted between October 2020 and January 2021. Inclusion criteria included age >65 years, presence of a minimum of two comorbidities in the subject, and consent to participate in the study. Standardized survey instruments such as Tilburg Frailty Indicator (TFI), Charlson Comorbidities Index (CCI), Assessment of Basic Activities of Daily Living—Katz Scale (ADL), and Assessment of Complex Activities of Daily Living—Lawton Scale (IADL) were used in the study. Results: The majority of the subjects (92) had a frailty syndrome (TFI). A small group of respondents (8%) suffered from severe comorbidities (CCI). Among the subjects surveyed, 71% maintained full function in performing simple activities of daily living (ADL), while 29% demonstrated moderate disability on the scale. Full independence in performing complex activities of daily living (IADL) was present in 33% of the respondents, and 67% were partially independent. Independence in complex activities of daily living (IADL) was significantly higher in patients with fewer comorbidities. The severity of comorbidities (CCI) had a significant effect on the decrease in the level of independence (ADL and IADL). Independence in performing complex activities (IADL) was worse among older patients. Conclusions: An increase in the number of comorbidities contributes to a decrease in the level of performance of complex activities of daily living. The severity of comorbidities significantly reduces the level of independence of the subjects in simple and complex activities of daily living. In patients with a higher level of independence in performing simple and complex activities, the co-occurrence of frailty syndrome was less severe. As the age of the subjects increases, the frequency in which they show moderate dependence on third parties in performing complex activities of daily living increases.
多病共存是一个全球性的常见问题。它会降低生活质量、导致残疾、增加住院频率和死亡的风险。本研究旨在评估多病共存与老年患者残疾之间的关系。
该研究纳入了 100 名患者，研究时间为 2020 年 10 月至 2021 年 1 月。纳入标准包括年龄>65 岁、患者存在至少两种合并症、并同意参与研究。研究中使用了标准化的调查工具，如蒂尔堡虚弱指数（TFI）、查尔森合并症指数（CCI）、基本日常生活活动评估-卡茨量表（ADL）和复杂日常生活活动评估-洛文量表（IADL）。
大多数患者（92 人）患有虚弱综合征（TFI）。一小部分患者（8%）患有严重的合并症（CCI）。在所调查的患者中，71%的人在进行简单日常生活活动（ADL）时完全能够自理，而 29%的人在量表上表现出中度残疾。33%的患者在进行复杂日常生活活动（IADL）时完全独立，67%的患者部分独立。患有较少合并症的患者在复杂日常生活活动（IADL）中的独立性更高。合并症的严重程度（CCI）对独立性下降（ADL 和 IADL）有显著影响。年龄较大的患者在进行复杂活动时独立性更差。
合并症数量的增加导致复杂日常生活活动能力的下降。合并症的严重程度显著降低了患者在简单和复杂日常生活活动中的独立性。在日常生活中简单和复杂活动独立性较高的患者中，虚弱综合征的发生率较低。随着患者年龄的增长，他们在进行复杂日常生活活动时对第三方的中度依赖程度增加。
