Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan; Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan; Division of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan; Department of Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
Arch Gerontol Geriatr. 2022 Sep-Oct;102:104741. doi: 10.1016/j.archger.2022.104741. Epub 2022 Jun 1.
Chronic obstructive pulmonary disease (COPD) is a common disease among older adults, leading to mortality. Although COPD is also associated with socioeconomic factors, little is known about the impact of COPD on mortality accounting for them. We examined the association between COPD and mortality among older male adults, adjusting for socioeconomic factors.
This study recruited functionally independent male older adults from the Japan Gerontological Evaluation Study. Participants answered self-reported questionnaires mailed in 2013, followed up to 2016. Participants with COPD were screened as those with higher scores than the upper quantile of the modified International Primary Care Airway Group questionnaire. Regarding individual socioeconomic factors, educational attainment, household equivalized income, living arrangements, and social participation was assessed. The Cox proportional hazards model was applied to examine the association between screened COPD and mortality.
Data of 6,662 male older adults were analyzed (mean age [standard deviation]: 73.0 [5.8] years). During the observation periods, 394 deaths (5.9%) occurred. Screened COPD was associated with an increased mortality risk, even after adjusting for socioeconomic factors (hazard ratio, 1.56; 95% confidence interval, 1.25-1.94). In the stratified analysis among current smokers, the mortality risk of screened COPD was high in those with lower education, higher income, living alone, and less social participation.
Those with screened COPD had an increased mortality risk, even after adjusting for socioeconomic factors. The risk was higher among those with lower education and less social relationships. Detection and treatment of COPD should be performed considering individual socioeconomic backgrounds.
慢性阻塞性肺疾病（COPD）是老年人常见的疾病，可导致死亡。尽管 COPD 也与社会经济因素有关，但对于其对死亡率的影响知之甚少。我们研究了 COPD 与老年男性死亡率之间的关系，并调整了社会经济因素。
本研究从日本老年评估研究中招募了功能独立的老年男性。参与者于 2013 年回答了邮寄的自我报告问卷，并于 2016 年进行了随访。将 COPD 患者筛选为改良国际初级保健气道组问卷得分高于上四分位数的患者。关于个体社会经济因素，评估了教育程度、家庭等效收入、居住安排和社会参与度。应用 Cox 比例风险模型检验筛选出的 COPD 与死亡率之间的关系。
共分析了 6662 名老年男性的数据（平均年龄[标准差]：73.0[5.8]岁）。在观察期间，有 394 人死亡（5.9%）。即使调整了社会经济因素，筛选出的 COPD 与死亡率增加相关（风险比，1.56；95%置信区间，1.25-1.94）。在当前吸烟者的分层分析中，在教育程度较低、收入较高、独居和社会参与度较低的患者中，筛选出的 COPD 死亡率较高。
即使调整了社会经济因素，筛选出的 COPD 患者的死亡率也会增加。在教育程度较低和社会关系较少的人群中，风险更高。应考虑个体的社会经济背景来检测和治疗 COPD。
