Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
JMIR Aging. 2024 Oct 15;7:e63024. doi: 10.2196/63024.
The co-occurrence of chronic illnesses and substance use presents complex challenges for health care systems. Understanding the interplay between these factors, compounded by the context of the COVID-19 pandemic, is essential for effective intervention strategies.
This study aims to investigate the relationships among chronic illness, substance use, and COVID-19 infection in adults aged 50 years and older.
Participants were 1196 adults aged 50 years and older. Descriptive statistics were used to describe demographic information. Logistic regressions and multiple regression analyses were used to determine associations between chronic illnesses, substance use, and COVID-19 infection. Mediation analysis was used to determine the effect of chronic illness mediators in the association between COVID-19 concerns and substance use.
The mean age was 68 (SD 10.3) years, with 58.6% (701/1196) being women. Adjusted analysis revealed that age and sex (women) significantly predicted a lower level of substance use (P<.05). However, marital status (separated or widowed) and chronic illness significantly predicted a higher level of substance use (P<.05). Furthermore, having dementia, arthritis, and high cholesterol significantly predicted a higher level of concern about the COVID-19 pandemic (P<.05). Logistic regression analysis indicated that individuals with hypertension (odds ratio [OR] 1.91, 95% CI 1.37-2.66; P<.001), lung disease (OR 2.42, 95% CI 1.23-4.75; P=.01), heart condition (OR 1.99, 95% CI 1.28-3.10; P=.002), stroke (OR 2.35, 95% CI 1.07-5.16; P=.03), and arthritis (OR 1.72, 95% CI 1.25-2.37; P=.001) were more likely to have their work affected by the COVID-19 pandemic. The mediation analysis showed a significant effect of COVID-19 concern on substance use through the mediation of chronic illness, with a 95% CI of -0.02 to -0.01 and an indirect effect of -0.01.
Our study reveals complex associations among chronic illnesses, substance use, and COVID-19 infection among adults aged 50 years and older. It underscores the impact of demographics and specific chronic conditions on substance use behaviors and COVID-19 concerns. In addition, certain chronic illnesses were linked to heightened vulnerability in employment status during the pandemic. These findings emphasize the need for targeted interventions addressing physical health and substance use in this population during the COVID-19 pandemic.
慢性病和物质使用的同时存在给医疗保健系统带来了复杂的挑战。了解这些因素之间的相互作用，以及 COVID-19 大流行背景下的相互作用，对于制定有效的干预策略至关重要。
本研究旨在调查 50 岁及以上成年人中慢性疾病、物质使用和 COVID-19 感染之间的关系。
参与者为 1196 名 50 岁及以上成年人。使用描述性统计数据描述人口统计学信息。使用逻辑回归和多元回归分析确定慢性疾病、物质使用和 COVID-19 感染之间的关联。使用中介分析确定 COVID-19 担忧与物质使用之间关联中慢性疾病中介的影响。
平均年龄为 68（SD 10.3）岁，其中 58.6%（701/1196）为女性。调整分析显示，年龄和性别（女性）显著预测物质使用水平较低（P<.05）。然而，婚姻状况（离异或丧偶）和慢性疾病显著预测物质使用水平较高（P<.05）。此外，患有痴呆症、关节炎和高胆固醇症显著预测对 COVID-19 大流行的担忧程度较高（P<.05）。逻辑回归分析表明，患有高血压（优势比 [OR] 1.91，95%置信区间 [CI] 1.37-2.66；P<.001）、肺部疾病（OR 2.42，95% CI 1.23-4.75；P=.01）、心脏疾病（OR 1.99，95% CI 1.28-3.10；P=.002）、中风（OR 2.35，95% CI 1.07-5.16；P=.03）和关节炎（OR 1.72，95% CI 1.25-2.37；P=.001）的个体更有可能其工作受到 COVID-19 大流行的影响。中介分析显示，COVID-19 担忧对物质使用的影响通过慢性疾病的中介作用显著，95%CI 为-0.02 至-0.01，间接影响为-0.01。
我们的研究揭示了 50 岁及以上成年人中慢性疾病、物质使用和 COVID-19 感染之间的复杂关联。它强调了人口统计学因素和特定慢性疾病对物质使用行为和 COVID-19 担忧的影响。此外，某些慢性疾病与大流行期间就业状况的脆弱性增加有关。这些发现强调了在 COVID-19 大流行期间针对这一人群的身体健康和物质使用问题进行有针对性干预的必要性。
