Chen Ye, Ji Huixia, Shen Yang, Liu Dandan
Department of Occupational Disease, Nanjing Prevention and Treatment Center for Occupational Diseases, Nanjing, Jiangsu, China.
Arch Public Health. 2024 Feb 1;82(1):17. doi: 10.1186/s13690-024-01243-2.
Owing to an increase in life expectancy, it is common for the older adults to suffer from chronic diseases that can result in disability and a low quality of life. This study aimed to explore the influence of chronic diseases and multimorbidities on activities of daily living (ADLs) and instrumental ADLs (IADLs) in an older Chinese population.
Based on the Chinese Longitudinal Healthy Longevity Survey (2018), 9,155 older adults aged 65 years and above were included in the study. A self-administered questionnaire was used to collect information on demographic characteristics, chronic diseases, ADLs, and IADLs. The impact of factors affecting ADL and IADL impairment in older adults was analysed using binary logistic regression.
In total, 66.3% participants had chronic diseases. Hypertension, heart disease, arthritis, diabetes and cerebrovascular disease were among the top chronic diseases. Of these, 33.7% participants had multimorbidities. The most common combination of the two chronic diseases was hypertension and heart disease (11.2%), whereas the most common combination of the three chronic diseases was hypertension, heart disease, and diabetes (3.18%). After categorising the older adults into four age groups, dementia, visual impairment, and hearing impairment were found to be more prevalent with increasing age. The prevalence of hypertension, heart disease, cerebrovascular disease, gastrointestinal ulcers, arthritis and chronic nephritis gradually increased with age until the age of 75 years, peaked in the 75-84 years age group, and then showed a decreasing trend with age. Multimorbidity prevalence followed a similar pattern. Regression analysis indicated that the increase in age group and the number of chronic diseases independently correlated with impairments in ADL as well as IADL. Additionally, gender, physical activity, educational background, obesity, depressive symptoms, and falls also had an impact on ADLs or IADLs.
Chronic diseases and multimorbidities are common in older adults, and it is important to note that aging, multimorbidity, obesity, and unhealthy lifestyle choices may interfere with ADLs or IADLs in older adults. Therefore, it is imperative that primary healthcare providers pay special attention to older adults and improve screening for multimorbidity and follow-up needs.
由于预期寿命的增加，老年人患慢性疾病的情况较为普遍，这些慢性病可能导致残疾和生活质量低下。本研究旨在探讨慢性疾病和多种慢性病共患对中国老年人群日常生活活动（ADL）和工具性日常生活活动（IADL）的影响。
基于中国老年健康影响因素跟踪调查（2018），本研究纳入了9155名65岁及以上的老年人。使用自填式问卷收集人口统计学特征、慢性疾病、ADL和IADL的信息。采用二元逻辑回归分析影响老年人ADL和IADL受损的因素。
共有66.3%的参与者患有慢性疾病。高血压、心脏病、关节炎、糖尿病和脑血管疾病是最常见的慢性病。其中，33.7%的参与者患有多种慢性病。两种慢性病最常见的组合是高血压和心脏病（11.2%），而三种慢性病最常见的组合是高血压、心脏病和糖尿病（3.18%）。将老年人分为四个年龄组后发现，痴呆、视力障碍和听力障碍的患病率随着年龄的增长而增加。高血压、心脏病、脑血管疾病、胃溃疡、关节炎和慢性肾炎的患病率随着年龄的增长逐渐上升，直到75岁，在75 - 84岁年龄组达到峰值，然后随着年龄的增长呈下降趋势。多种慢性病共患的患病率也呈现类似的模式。回归分析表明，年龄组的增加和慢性疾病的数量与ADL以及IADL的受损独立相关。此外，性别、身体活动、教育背景、肥胖、抑郁症状和跌倒也对ADL或IADL有影响。
慢性疾病和多种慢性病共患在老年人中很常见，需要注意的是，衰老、多种慢性病共患、肥胖和不健康的生活方式选择可能会干扰老年人的ADL或IADL。因此，初级医疗保健提供者必须特别关注老年人，并加强对多种慢性病共患情况的筛查以及后续需求的跟踪。
