Centre d'Estudis Demogràfics, Bellaterra, Spain.
Int J Public Health. 2023 Oct 18;68:1606259. doi: 10.3389/ijph.2023.1606259. eCollection 2023.
To investigate changes in multimorbidity patterns among Spanish older adults. Data come from the Spanish National Health Survey (ENSE) for individuals aged 60-89 years (2006: = 9,758; 2017: = 8,535). Prevalence rates and relative risks of 20 chronic conditions are estimated for the multimorbidity (3+ chronic conditions) sample, along with observed-to-expected prevalence of three-way disease combinations. Principal component and cluster analyses identify multimorbidity patterns and track temporal changes. Overall, multimorbidity remained stable [2006: 59.6% (95% CI: 58.7%-60.6%); 2017: 60.3% (CI: 59.3%-61.3%)], except at older ages. Women exhibited higher multimorbidity prevalence, but sex differences declined by five percentage points. Low-high education differences widened by three percentage points. In 2017 most individuals living with multimorbidity experienced hypertension (63.4%), osteoarthrosis (62.4%) and chronic back pain (55.9%). These chronic conditions also dominate the most common triadic combinations. Multimorbid men also saw increases in cholesterol and diabetes. Multimorbidity trends and the most common combination of diseases can help plan healthcare for an ageing population. Sex and socioeconomic differences pose additional public health challenges as women and deprived populations tend to have more health complexities.
研究西班牙老年人多病共存模式的变化。数据来自西班牙国家健康调查（ENSE），对象为 60-89 岁的个体（2006 年：n=9758；2017 年：n=8535）。对患有三种及以上慢性疾病的个体样本，估计了 20 种慢性疾病的患病率和相对风险，并观察到了三种疾病组合的预期患病率。主成分和聚类分析确定了多病共存模式，并跟踪了时间变化。总体而言，多病共存保持稳定[2006 年：59.6%（95%置信区间：58.7%-60.6%）；2017 年：60.3%（CI：59.3%-61.3%）]，但在老年人群体中有所增加。女性表现出更高的多病共存患病率，但性别差异下降了五个百分点。低高教育差异扩大了三个百分点。2017 年，大多数患有多病共存的个体患有高血压（63.4%）、骨关节炎（62.4%）和慢性背痛（55.9%）。这些慢性疾病也主导着最常见的三联组合。患有多病共存的男性也看到了胆固醇和糖尿病的增加。多病共存趋势和最常见的疾病组合可以帮助规划老龄化人口的医疗保健。性别和社会经济差异带来了额外的公共卫生挑战，因为女性和贫困人群往往面临更多的健康复杂性。
