多种共存疾病对中国老年人群死亡率的影响。
Effects of multimorbidity coexistence on the risk of mortality in the older adult population in China.
机构信息
School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
出版信息
Front Public Health. 2023 Apr 5;11:1110876. doi: 10.3389/fpubh.2023.1110876. eCollection 2023.
BACKGROUND
Multimorbidity coexistence is a serious public health issue affecting a significant number of older adults worldwide. However, associations between multimorbidity and mortality are rarely studied in China. We assessed the effects of multimorbidity coexistence on mortality among a nationwide sample of older adults from China.
OBJECTIVE
We analyzed 10-year (2008-2018) longitudinal data of 12,337 individuals who took part in China, a nationwide survey of people aged 65 years and above. We used the Cox proportional hazard model to determine the effects of multimorbidity on the all-cause mortality risk. We also examined mortality risk between sex and age obtained through differential analysis.
RESULTS
At baseline, 30.2, 29.9, and 39.9% of participants had 0, 1, and 2 or more diseases, respectively. The cumulative follow-up of this study was 27,428 person-years (median follow-up = 2.7 years; range, 0.01-11.3 years), with 8297 deaths. The HRs (95% CIs) for all-cause mortality in participants with 1, and 2 or more conditions compared with those with none were 1.04 (0.98, 1.10) and 1.12 (1.06, 1.18), respectively. The heterogeneity analysis indicated that, the mortality risk for 80-94 years and 95-104 years group with multimorbidity coexistence is 1.12 (1.05-1.21) and 1.11 (1.01-1.23), respectively, but the mortality risk for 65-79 years group with multimorbidity coexistence was not statistically significant. The heterogeneity analysis indicated that, the mortality risk for men and women in older adults with multimorbidity coexistence is 1.15 (1.06, 1.25) and 1.08 (1.01, 1.17), respectively.
CONCLUSION
Multimorbidity coexistence is associated with an increase in an increased risk of death in older individuals, with the effect being relatively significant in those aged 80-94 years.
背景
多种疾病共存是一个严重的公共卫生问题,影响着全球大量的老年人。然而,在中国,很少有研究探讨多种疾病共存与死亡率之间的关系。我们评估了全国范围内老年人样本中多种疾病共存对死亡率的影响。
目的
我们分析了参加中国老年人全国性调查的 12337 名 65 岁及以上人群的 10 年(2008-2018 年)纵向数据。我们使用 Cox 比例风险模型来确定多种疾病共存对全因死亡率风险的影响。我们还通过差异分析检查了性别和年龄之间的死亡率风险。
结果
在基线时,分别有 30.2%、29.9%和 39.9%的参与者患有 0、1 种和 2 种或更多疾病。这项研究的累计随访时间为 27428 人年(中位数随访时间为 2.7 年;范围为 0.01-11.3 年),共有 8297 人死亡。与无疾病的参与者相比,患有 1 种和 2 种或更多疾病的参与者全因死亡率的 HR(95%CI)分别为 1.04(0.98,1.10)和 1.12(1.06,1.18)。异质性分析表明,80-94 岁和 95-104 岁组多种疾病共存的死亡风险分别为 1.12(1.05-1.21)和 1.11(1.01-1.23),而 65-79 岁组多种疾病共存的死亡风险无统计学意义。异质性分析表明,老年人中多种疾病共存的男性和女性的死亡风险分别为 1.15(1.06,1.25)和 1.08(1.01,1.17)。
结论
多种疾病共存与老年人死亡风险增加相关,这种影响在 80-94 岁人群中相对显著。
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