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多重疾病集群及其对高龄老人幸福感的影响:基于德国全国代表性样本的结果

Multimorbidity clusters and their contribution to well-being among the oldest old: Results based on a nationally representative sample in Germany.

作者信息

Hajek André, Gyasi Razak M, Kostev Karel, Soysal Pinar, Veronese Nicola, Smith Lee, Jacob Louis, Oh Hans, Pengpid Supa, Peltzer Karl, König Hans-Helmut

机构信息

Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.

African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.

出版信息

Arch Gerontol Geriatr. 2025 Mar;130:105726. doi: 10.1016/j.archger.2024.105726. Epub 2024 Dec 15.

Abstract

AIM

Our aim was to identify multimorbidity clusters and, in particular, to examine their contribution to well-being outcomes among the oldest old in Germany.

METHODS

Data were taken from the large nationally representative D80+ study including community-dwelling and institutionalized individuals aged 80 years and over residing in Germany (n = 8,773). The mean age was 85.6 years (SD: 4.1). Based on 21 chronic conditions, latent class analysis was carried out to explore multimorbidity (≥2 chronic conditions) clusters. Widely used tools were applied to quantify well-being outcomes.

RESULTS

Approximately nine out of ten people aged 80 and over living in Germany were multimorbid. Four multimorbidity clusters were identified: relatively healthy class (30.2 %), musculoskeletal class (44.8 %), mental illness class (8.6 %), and high morbidity class (16.4 %). Being part of the mental disorders cluster was consistently linked to reduced well-being (in terms of low life satisfaction, high loneliness and lower odds of meaning in life), followed by membership in the high morbidity cluster.

CONCLUSIONS

Four multimorbidity clusters were detected among the oldest old in Germany. Particularly belonging to the mental disorders cluster is consistently associated with low well-being, followed by belonging to the high morbidity cluster. This stresses the need for efforts to target such vulnerable groups, pending future longitudinal research.

摘要

目的

我们的目的是识别多重疾病集群,特别是研究它们对德国高龄老年人幸福状况的影响。

方法

数据取自具有全国代表性的大型D80+研究,该研究涵盖居住在德国的80岁及以上的社区居民和机构养老人员(n = 8773)。平均年龄为85.6岁(标准差:4.1)。基于21种慢性病,进行潜在类别分析以探索多重疾病(≥2种慢性病)集群。使用广泛应用的工具来量化幸福状况。

结果

居住在德国的80岁及以上人群中,约十分之九患有多种疾病。识别出四个多重疾病集群:相对健康组(30.2%)、肌肉骨骼组(44.8%)、精神疾病组(8.6%)和高发病率组(16.4%)。属于精神障碍集群始终与幸福感降低相关(表现为生活满意度低、孤独感高和生活意义感较低的几率),其次是属于高发病率集群。

结论

在德国高龄老年人中检测到四个多重疾病集群。特别是属于精神障碍集群始终与幸福感低相关,其次是属于高发病率集群。这强调了在未来进行纵向研究之前,针对此类弱势群体开展工作的必要性。

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