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美国退伍军人的功能障碍:综合整体健康计划的重要性。

Functional Disability in US Military Veterans: The Importance of Integrated Whole Health Initiatives.

机构信息

VA Connecticut Healthcare System, West Haven.

Department of Psychiatry, University of Connecticut School of Medicine, Farmington.

出版信息

Prim Care Companion CNS Disord. 2023 Jul 4;25(4):22m03461. doi: 10.4088/PCC.22m03461.

Abstract

To examine the prevalence and sociodemographic, medical, and psychiatric correlates of disability in activities of daily living (ADLs) and instrumental ADLs (IADLs) in the US veteran population. Data were analyzed from 4,069 US veterans who participated in the 2019-2020 National Health and Resilience in Veterans Study (NHRVS). Multivariable and relative importance analyses (RIAs) were conducted to identify independent and strongest correlates of ADL and IADL disability. A total of 5.2% (95% CI, 4.4%-6.2%) and 14.2% (95% CI, 12.8%-15.7%) of veterans reported ADL and IADL disability, respectively. Older age, male sex, Black race, lower income, and deployment-related injuries were associated with ADL and IADL disabilities, as were certain medical and cognitive conditions. Results of RIAs revealed that sleep disorders, diabetes, posttraumatic stress disorder (PTSD), older age, and cognitive disorders were most strongly associated with ADL disability, while chronic pain, PTSD, lower income, and sleep and cognitive disorders were most strongly associated with IADL disability. Results of this study provide an up-to-date estimate of the prevalence and sociodemographic, military, and health correlates of functional disability in US veterans. Improved identification and integrated clinical management of these risk factors may help mitigate disability risk and promote the maintenance of functional capacity in this population. .

摘要

为了检查美国退伍军人中日常生活活动(ADLs)和工具性日常生活活动(IADLs)残疾的流行率以及社会人口学、医学和精神相关因素。对参加了 2019-2020 年国家健康和退伍军人复原力研究(NHRVS)的 4069 名美国退伍军人的数据进行了分析。进行了多变量和相对重要性分析(RIAs),以确定 ADL 和 IADL 残疾的独立和最强相关因素。分别有 5.2%(95%置信区间,4.4%-6.2%)和 14.2%(95%置信区间,12.8%-15.7%)的退伍军人报告 ADL 和 IADL 残疾。年龄较大、男性、黑人、收入较低和与部署相关的伤害与 ADL 和 IADL 残疾相关,某些医疗和认知状况也是如此。RIAs 的结果表明,睡眠障碍、糖尿病、创伤后应激障碍(PTSD)、年龄较大以及认知障碍与 ADL 残疾最相关,而慢性疼痛、PTSD、较低的收入以及睡眠和认知障碍与 IADL 残疾最相关。这项研究的结果提供了美国退伍军人功能残疾的流行率以及社会人口学、军事和健康相关因素的最新估计。更好地识别和综合管理这些危险因素可能有助于降低残疾风险,并促进该人群的功能能力维持。

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