台湾老年人的多重疾病模式及其与新发残疾和衰弱的关系：一项基于人群的16年队列研究。

Multimorbidity patterns and their relationships with incident disability and frailty among older adults in Taiwan: A 16-year, population-based cohort study.

作者信息

Ho Hsin-En, Yeh Chih-Jung, Wei James Cheng-Chung, Chu Wei-Min, Lee Meng-Chih

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan.

School of Public Health, Chung-Shan Medical University, Taichung, Taiwan.

出版信息

Arch Gerontol Geriatr. 2022 Jul-Aug;101:104688. doi: 10.1016/j.archger.2022.104688. Epub 2022 Mar 20.

DOI:10.1016/j.archger.2022.104688

PMID:35349876

Abstract

BACKGROUND

Multimorbidity has negative impacts on the health outcomes of older adults. Previous research has discovered different patterns of multimorbidity. However, evidence is scarce for associations between multimorbidity patterns and disability/frailty, especially evidence from longitudinal studies. This study aimed to explore the relationship between multimorbidity patterns and disability/frailty among older adults in Taiwan.

METHODS

This population-based cohort study used data from the Taiwan Longitudinal Study on Aging. It included 2,194 older adults (age >50 years) who were followed from 1996 to 2011. The participants' multimorbidity patterns in 1996 were determined by latent class analysis; their incident disability and frailty were ascertained in 2011. Multivariate logistic regression was used to analyze the relationship between multimorbidity patterns and disability/frailty.

RESULTS

In 1996, the participants' average age was 62 years. Four multimorbidity patterns were discovered through latent class analysis, as follows: (1) Cardiometabolic group (n = 222), (2) Arthritis-cataract group (n = 112), (3) Multimorbidity group (n = 189), and (4) Relatively healthy group (n = 1671). After adjusting for age, sex, social participation, alcohol consumption, self-rated health, admission in the past year, and depression, participants in the Cardiometabolic group had a greater risk of incident disability (odds ratio: 1.78; 95% confidence interval: 1.26-2.52), compared with the Relatively healthy group. No statistically significant relationships were found between multimorbidity patterns and frailty. Subgroup analysis showed that females in the Cardiometabolic and Multimorbidity groups had greater risks of developing disability.

CONCLUSION

This 16-year, population-based cohort study showed that distinct multimorbidity patterns among older adults in Taiwan were associated with incident disability during later life but were not related to frailty.

摘要

背景

多病共存对老年人的健康结局有负面影响。以往研究发现了不同的多病共存模式。然而，关于多病共存模式与残疾/衰弱之间关联的证据稀缺，尤其是来自纵向研究的证据。本研究旨在探讨台湾老年人中多病共存模式与残疾/衰弱之间的关系。

方法

这项基于人群的队列研究使用了台湾老年纵向研究的数据。研究纳入了1996年至2011年期间随访的2194名老年人（年龄>50岁）。通过潜在类别分析确定了参与者在1996年的多病共存模式；在2011年确定了他们新发的残疾和衰弱情况。采用多变量逻辑回归分析多病共存模式与残疾/衰弱之间的关系。

结果

1996年，参与者的平均年龄为62岁。通过潜在类别分析发现了四种多病共存模式，如下：（1）心血管代谢组（n = 222），（2）关节炎 - 白内障组（n = 112），（3）多病共存组（n = 189），以及（4）相对健康组（n = 1671）。在调整了年龄、性别、社会参与、饮酒情况、自评健康状况、过去一年的住院情况和抑郁因素后，与相对健康组相比，心血管代谢组的参与者发生残疾的风险更高（优势比：1.78；95%置信区间：1.26 - 2.52）。未发现多病共存模式与衰弱之间存在统计学上的显著关系。亚组分析表明，心血管代谢组和多病共存组中的女性发生残疾的风险更高。