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综合医疗保健系统对墨西哥北部百岁老人群体长寿的影响:一项观察性研究。

The impact of an integrative healthcare system on longevity in a nonagenarian population in Northern Mexico: an observational study.

作者信息

Hughes-García Melissa, Ojeda-Salazar Daniela Abigail, Rivera-Cavazos Andrea, Garza-Silva Arnulfo, Cepeda-Medina Andrea Belinda, Fernández-Chau Iván Francisco, Morales-Rodriguez Devany Paola, Sanz-Sánchez Miguel Ángel, González-Cantú Arnulfo, Romero-Ibarguengoitia Maria Elena

机构信息

Geriatrics Department, Hospital Clinica Nova de Monterrey, San Nicolás de los Garza, Nuevo Leon, Mexico.

Research Department, Hospital Clinica Nova de Monterrey, San Nicolás de los Garza, Nuevo Leon, Mexico.

出版信息

Arch Public Health. 2024 Sep 9;82(1):150. doi: 10.1186/s13690-024-01359-5.

Abstract

BACKGROUND

Despite the growth in the older population, there is a noticeable research gap regarding integrative health systems for older people and their impact on longevity in nonagenarians. This study aimed to evaluate the effect of an integrative health system consisting of medical services, recreational facilities, and housing on longevity in a population of nonagenarians in Northern Mexico.

METHODS

This was a cross-sectional, retrospective, descriptive-analytical study in which we measured and analyzed medical history such as number of hospitalizations, visits to geriatric consultation, hypertension, history of chronic pain, polypharmacy, dementia, rheumatic disease, diabetes mellitus, insomnia, depression, ischemic cardiomyopathy, among others. We also measured social engagement and number of caregivers. A logistic regression was performed to evaluate the predictors of mortality in this population.

RESULTS

We included one hundred and ninety-five nonagenarians with a mean (SD) age of 94 (4.2) years and of which 112 (55.7%) were female. The findings from logistic regression analysis indicated that a higher frequency of hospitalizations was associated with an elevated mortality risk (OR = 1.272, p = 0.049). Conversely, increased visits to geriatric consultation services as primary care were linked to a reduced mortality risk (OR = 0.953, p = 0.002). Additionally, social engagement displayed a protective effect (OR = 0.336, p = 0.05).

CONCLUSIONS

This study highlighted the role of systemic health approaches in extending life through insights into nonagenarian patients' involvement in primary care, as measured by consultation frequency, and participation in social activities, mitigating mortality risks. Meanwhile, it emphasized the potential consequences of higher hospitalization rates on increased mortality risk.

摘要

背景

尽管老年人口在增长,但关于老年人综合健康系统及其对九旬老人长寿影响的研究仍存在显著差距。本研究旨在评估由医疗服务、娱乐设施和住房组成的综合健康系统对墨西哥北部九旬老人群体长寿的影响。

方法

这是一项横断面、回顾性、描述性分析研究,我们测量并分析了病史,如住院次数、老年科会诊次数、高血压、慢性疼痛史、多重用药、痴呆、风湿性疾病、糖尿病、失眠、抑郁、缺血性心肌病等。我们还测量了社会参与度和护理人员数量。进行逻辑回归分析以评估该人群死亡率的预测因素。

结果

我们纳入了195名九旬老人,平均(标准差)年龄为94(4.2)岁,其中112名(55.7%)为女性。逻辑回归分析结果表明,较高的住院频率与死亡风险升高相关(比值比=1.272,p=0.049)。相反,作为初级保健的老年科会诊服务就诊次数增加与死亡风险降低相关(比值比=0.953,p=0.002)。此外,社会参与度显示出保护作用(比值比=0.336,p=0.05)。

结论

本研究通过对九旬患者参与初级保健(以会诊频率衡量)和参与社会活动情况的洞察,突出了系统健康方法在延长寿命方面的作用,降低了死亡风险。同时,强调了较高住院率对死亡风险增加的潜在影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05da/11382524/02069532a45a/13690_2024_1359_Fig1_HTML.jpg

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