中国老年人群中多种疾病共存与内在能力之间的关联：基于中国健康与养老追踪调查（CHARLS）2011 - 2015年数据的证据

Association between multimorbidity and intrinsic capacity among older Chinese adults: evidence from the CHARLS 2011-2015.

作者信息

Zhang Mengyuan, Xu Yanlong, Xing Yan, Li Hongqi

机构信息

Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.

Department of Environmental Health, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, 230001, China.

出版信息

Eur Geriatr Med. 2025 May 26. doi: 10.1007/s41999-025-01232-w.

DOI:10.1007/s41999-025-01232-w

PMID:40418266

Abstract

PURPOSE

To investigate the relationships between multimorbidity, patterns, and intrinsic capacity (IC) transitions in older Chinese adults.

METHODS

The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. IC evaluations were conducted in 2011 and 2015, encompassing cognition capacity, locomotion capacity, vitality capacity, psychological capacity, and sensory capacity. Based on the IC status in 2011 and 2015, four distinct IC transitions were defined. Multimorbidity patterns were determined at baseline through latent class analysis involving 14 chronic conditions. The associations between multimorbidity patterns and IC transitions were examined using multinomial logistic regression.

RESULTS

Among 3569 participants aged 60 and above, 53.0% were male, with a median age of 65 years. Regarding their condition counts, 10.9% had no disease, 24.3% had only one disease, and 64.8% had multimorbidity. Within the group with multimorbidity, 58.0% experienced sustained impairment in IC, a notably higher percentage compared to those with no disease (45.6%) and those with only one disease (50.6%). Compared to those with no disease, multimorbidity was significantly associated with IC sustained impairment after adjusting for all covariates (OR = 1.64; 95%CI = 1.20-2.23). Among the 2314 participants with multimorbidity, three multimorbidity patterns were identified: metabolic pattern (27.1%), arthritis-stomach pattern (64.5%), and respiratory pattern (8.4%). Compared to the metabolic pattern, the arthritis-stomach and respiratory patterns exhibited a higher risk of sustained impairment in IC; however, there was no significant difference observed between the latter two multimorbidity patterns.

CONCLUSIONS

Multimorbidity was associated with sustained impairment IC among older Chinese adults. Compared to the metabolic pattern, both the arthritis-stomach and respiratory patterns exhibited a notably elevated risk of sustained impairment IC.

摘要

目的

研究中国老年人群中多种疾病并存情况、模式与内在能力（IC）转变之间的关系。

方法

数据来源于2011年至2015年的中国健康与养老追踪调查（CHARLS）。2011年和2015年进行了IC评估，包括认知能力、运动能力、活力能力、心理能力和感官能力。根据2011年和2015年的IC状况，定义了四种不同的IC转变。通过对14种慢性病进行潜在类别分析，在基线时确定多种疾病并存模式。使用多项逻辑回归分析多种疾病并存模式与IC转变之间的关联。

结果

在3569名60岁及以上的参与者中，53.0%为男性，中位年龄为65岁。就疾病数量而言，10.9%无疾病，24.3%仅患一种疾病，64.8%患有多种疾病。在患有多种疾病的人群中，58.0%的IC持续受损，这一比例明显高于无疾病者（45.6%）和仅患一种疾病者（50.6%）。与无疾病者相比，在调整所有协变量后，多种疾病并存与IC持续受损显著相关（OR = 1.64；95%CI = 1.20 - 2.23）。在2314名患有多种疾病的参与者中，确定了三种多种疾病并存模式：代谢模式（27.1%）、关节炎 - 胃部模式（64.5%）和呼吸模式（8.4%）。与代谢模式相比，关节炎 - 胃部模式和呼吸模式表现出更高的IC持续受损风险；然而，后两种多种疾病并存模式之间未观察到显著差异。