Prasad Anyah, Nunes Anthony P, Jesdale Bill M, Nielsen Natalia N, Dubé Catherine E, Mack Deborah S, Lapane Kate L
Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Department of Gerontology, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA, USA.
Aging Health Res. 2025 Jun;5(2). doi: 10.1016/j.ahr.2025.100230. Epub 2025 Apr 15.
Social engagement is an important determinant of health in older adults. Skin ulcers may adversely impact social engagement among nursing home residents. This study sought to quantify the differential associations between pressure and stasis ulcers and social engagement among long-stay US nursing home residents.
Cross-sectional, nationally representative data was obtained from the Minimum Data Set 2.0 on US nursing home residents aged ≥ 50 years with an annual assessment between Oct 1, 2009 and Sept 30, 2010. Adjusted prevalence ratios (aPR) of low social engagement among residents with the four stages of pressure and stasis ulcers and 95 % confidence intervals (CI) were estimated from multivariable Poisson models using a generalized estimating equation approach to account for residents nested within nursing homes.
Among the 771,634 residents, 4.5 % had pressure ulcers, and 1.1 % had stasis ulcers. The presence of pressure ulcers, regardless of the stage, was associated with an increased risk of low social engagement (stage 1 aPR: 1.05 (95 % CI: 1.03-1.07); stage 4 aPR: 1.07 (95 % CI: 1.05-1.08)). Residents with stage 1 to 3 stasis ulcers were less likely than those without any skin ulcers to have low social engagement. In contrast, those with stage 4 stasis ulcers had an increased prevalence of low social engagement (aPR: 1.10 (95 % CI: 1.06-1.14)).
Social engagement should be monitored and addressed in residents with skin ulcers. Since pressure and stasis ulcers have different etiologies and treatment modalities, they should be considered separately in the empirical work on their association with social engagement.
社交参与是老年人健康的重要决定因素。皮肤溃疡可能会对养老院居民的社交参与产生不利影响。本研究旨在量化美国长期居住养老院居民中压力性溃疡和淤血性溃疡与社交参与之间的差异关联。
从2.0版最小数据集获取了具有全国代表性的横断面数据，数据来自于2009年10月1日至2010年9月30日期间接受年度评估的年龄≥50岁的美国养老院居民。使用广义估计方程方法，从多变量泊松模型估计压力性溃疡和淤血性溃疡四个阶段的居民中社交参与度低的调整患病率比（aPR）和95%置信区间（CI），以考虑居民嵌套在养老院中的情况。
在771,634名居民中，4.5%患有压力性溃疡，1.1%患有淤血性溃疡。无论处于哪个阶段，压力性溃疡的存在都与社交参与度低的风险增加相关（1期aPR：1.05（95%CI：1.03 - 1.07）；4期aPR：1.07（95%CI：1.05 - 1.08））。1至3期淤血性溃疡的居民比没有任何皮肤溃疡的居民社交参与度低的可能性更小。相比之下，4期淤血性溃疡的居民社交参与度低的患病率增加（aPR：1.10（95%CI：1.06 - 1.14））。
对于有皮肤溃疡的居民，应监测并关注其社交参与情况。由于压力性溃疡和淤血性溃疡有不同的病因和治疗方式，在关于它们与社交参与关联的实证研究中应分别予以考虑。
