Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
Geriatr Gerontol Int. 2023 Sep;23(9):684-691. doi: 10.1111/ggi.14647. Epub 2023 Aug 9.
This study aimed to explore the association between multimorbidity patterns with/without frailty and future mortality among Taiwanese middle-aged and older adults through a population-based cohort study design.
Data were collected from the Taiwan Longitudinal Study on Aging. The data were obtained from Wave 3, with the multimorbidity patterns in the years of 1996 being analyzed through latent class analysis. Frailty was defined using the modified Fried criteria. The association between each disease group with/without frailty and mortality was examined using logistic regression, with the reference group as the Relatively healthy group without frailty. Survival analysis was performed using Cox regression, and the follow-up period of mortality was from 1 January 1996 to 31 December 2012.
A total of 4748 middle-aged and older adults with an average age of 66.3 years (SD: 9.07 years) were included. Four disease patterns were identified in 1996, namely the Cardiometabolic (21.0%), Arthritis-cataract (11.9%), Relatively healthy (61.6%), and Multimorbidity (5.5%) groups. After adjusting for all covariates, the Relatively healthy group with frailty showed the highest risk for mortality (odds ratio: 3.66, 95% confidence interval [95% CI]: 2.24-5.95), followed by the Cardiometabolic group with frailty (odds ratio: 3.58, 95% CI: 1.96-6.54), Multimorbidity group with frailty (odds ratio: 2.28, 95% CI: 1.17-4.44), Multimorbidity group without frailty (odds ratio: 1.44, 95% CI: 1.01-2.04), and the Cardiometabolic group without frailty (odds ratio: 1.24, 95% CI: 1.04-1.49).
Frailty plays an important role in mortality among middle-aged and older adults with distinct multimorbidity patterns. Middle-aged and older adults with a relatively healthy multimorbidity pattern or a cardiometabolic multimorbidity pattern with frailty encountered dismal outcomes. Geriatr Gerontol Int 2023; 23: 684-691.
本研究旨在通过一项基于人群的队列研究设计，探讨台湾中老年人群中存在/不存在衰弱的多种疾病模式与未来死亡率之间的关系。
数据来自台湾老龄化纵向研究。数据来自第 3 波，通过潜在类别分析分析 1996 年的多种疾病模式。使用改良的 Fried 标准定义衰弱。使用逻辑回归检查每个疾病组与/不伴有衰弱与死亡率之间的关系，参考组为不伴有衰弱的相对健康组。使用 Cox 回归进行生存分析，死亡率的随访时间为 1996 年 1 月 1 日至 2012 年 12 月 31 日。
共纳入 4748 名平均年龄 66.3 岁（标准差：9.07 岁）的中老年人。1996 年确定了四种疾病模式，分别为心血管代谢（21.0%）、关节炎-白内障（11.9%）、相对健康（61.6%）和多种疾病（5.5%）组。在调整所有协变量后，伴有衰弱的相对健康组死亡率风险最高（优势比：3.66，95%置信区间[95%CI]：2.24-5.95），其次是伴有衰弱的心血管代谢组（优势比：3.58，95%CI：1.96-6.54），伴有衰弱的多种疾病组（优势比：2.28，95%CI：1.17-4.44），不伴有衰弱的多种疾病组（优势比：1.44，95%CI：1.01-2.04）和不伴有衰弱的心血管代谢组（优势比：1.24，95%CI：1.04-1.49）。
衰弱在具有不同多种疾病模式的中老年人群的死亡率中起着重要作用。患有相对健康的多种疾病模式或伴有心血管代谢的多种疾病模式且衰弱的中老年人群预后较差。老年医学与老年病学国际 2023；23：684-691。
