Department of Gerontology, Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada.
School of Social Work, MacEwan University, Edmonton, AB, Canada.
Front Public Health. 2022 Sep 23;10:896312. doi: 10.3389/fpubh.2022.896312. eCollection 2022.
There has been a growing interest in examining why some individuals adapt and bounce back from multimorbidity (resilience) better than others. This paper investigates the positive role of protective health behaviors on multimorbidity resilience (MR) among older adults focusing on older persons with two or more concurrent chronic conditions, and separately for three multimorbidity chronic illness clusters.
Using Baseline and Follow-up One data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 10,628 participants aged 65 years and older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: Cardiovascular/metabolic, Musculoskeletal, and Mental health. Associations between health behaviors and MR were evaluated using Linear Mixed Models, adjusting for socio-demographic, social/environmental, and illness context social determinants of health.
Among older adults with two or more illnesses, smoking, satisfaction with sleep, appetite, and skipping meals were associated with MR in the expected direction. Also, obesity (compared to normal weight) and skipping meals showed longitudinal interaction effects with survey wave. Most of the results were replicated for the physical multimorbidity clusters (Cardiovascular/metabolic and Musculoskeletal) compared to the full 2+ multimorbidity analyses; however, for the Mental health cluster, only satisfaction with sleep was supported as a lifestyle predictor of MR.
Several modifiable health behaviors identified in the broader health and aging literature are important in affecting levels of multimorbidity resilience in older age. These factors are important strength-based areas to target. Additionally, several social determinants of health are also supported and parallel research on multimorbidity risk. The effects of lifestyle factors for resilience among older adults is dependent on the type of multimorbidity measured. We conclude that the results have significant public health, program intervention, and clinical implications for healthy aging among persons coping with multimorbidity.
人们越来越关注研究为什么有些人能够更好地适应和从多种疾病（韧性）中恢复过来。本文探讨了保护健康行为对老年人多种疾病韧性（MR）的积极作用，重点关注有两种或两种以上并存慢性疾病的老年人，以及三种多种疾病慢性疾病集群分别。
使用加拿大老龄化纵向研究综合队列的基线和随访数据，我们研究了 10628 名年龄在 65 岁及以上的参与者，他们报告了 27 种慢性疾病中的两种或两种以上，以及三种多种疾病集群：心血管/代谢、肌肉骨骼和心理健康。使用线性混合模型评估健康行为与 MR 之间的关联，调整了社会人口统计学、社会/环境和疾病背景下的健康社会决定因素。
在有两种或两种以上疾病的老年人中，吸烟、睡眠满意度、食欲和不吃饭与 MR 呈预期方向相关。此外，肥胖（与正常体重相比）和不吃饭与调查波之间存在纵向交互效应。与全面的 2+多种疾病分析相比，这些结果在身体多种疾病集群（心血管/代谢和肌肉骨骼）中得到了复制；然而，对于心理健康集群，只有睡眠满意度被认为是预测 MR 的生活方式因素。
在更广泛的健康和老龄化文献中确定的几种可改变的健康行为对于影响老年人多种疾病韧性水平非常重要。这些因素是重要的基于优势的目标领域。此外，一些健康社会决定因素也得到了支持，并与多种疾病风险的平行研究相呼应。生活方式因素对老年人韧性的影响取决于所测量的多种疾病类型。我们得出结论，这些结果对健康老龄化人群的健康老龄化、计划干预和临床具有重要的公共卫生意义。
