College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
J Gerontol A Biol Sci Med Sci. 2024 Jul 1;79(7). doi: 10.1093/gerona/glae122.
The rapidly growing field of multimorbidity research demonstrates that changes in multimorbidity in mid- and late-life have far reaching effects on important person-centered outcomes, such as health-related quality of life. However, there are few organizing frameworks and comparatively little work weighing the merits and limitations of various quantitative methods applied to the longitudinal study of multimorbidity.
We identify and discuss methods aligned to specific research objectives with the goals of (i) establishing a common language for assessing longitudinal changes in multimorbidity, (ii) illuminating gaps in our knowledge regarding multimorbidity progression and critical periods of change, and (iii) informing research to identify groups that experience different rates and divergent etiological pathways of disease progression linked to deterioration in important health-related outcomes.
We review practical issues in the measurement of multimorbidity, longitudinal analysis of health-related data, operationalizing change over time, and discuss methods that align with 4 general typologies for research objectives in the longitudinal study of multimorbidity: (i) examine individual change in multimorbidity, (ii) identify subgroups that follow similar trajectories of multimorbidity progression, (iii) understand when, how, and why individuals or groups shift to more advanced stages of multimorbidity, and (iv) examine the coprogression of multimorbidity with key health domains.
This work encourages a systematic approach to the quantitative study of change in multimorbidity and provides a valuable resource for researchers working to measure and minimize the deleterious effects of multimorbidity on aging populations.
多病共存研究领域的迅速发展表明,中老年多病共存状况的变化对健康相关生活质量等重要以人为本的结果有着深远的影响。然而,目前几乎没有组织框架,也很少有工作权衡应用于多病共存纵向研究的各种定量方法的优缺点。
我们确定并讨论了与特定研究目标一致的方法,目标是:(i) 为评估多病共存的纵向变化建立共同语言;(ii) 阐明我们对多病共存进展和关键变化期的认识差距;以及 (iii) 为研究提供信息,以确定那些经历不同疾病进展速度和不同病因途径的群体,这些群体与重要健康相关结果的恶化有关。
我们回顾了多病共存的测量、与健康相关数据的纵向分析、随时间变化的操作化等实际问题,并讨论了与多病共存纵向研究的 4 种一般研究目标类型一致的方法:(i) 检查多病共存的个体变化;(ii) 确定遵循相似多病共存进展轨迹的亚组;(iii) 了解个人或群体何时、如何以及为何转变为多病共存的更高级阶段;以及 (iv) 研究多病共存与主要健康领域的共同进展。
这项工作鼓励对多病共存变化的定量研究采用系统方法,并为努力测量和减轻多病共存对老年人口的不利影响的研究人员提供了有价值的资源。