首页|中国≥45岁中老年人多重慢性病模式与日常和工具性日常生活活动能力残疾的关联性

中国≥45岁中老年人多重慢性病模式与日常和工具性日常生活活动能力残疾的关联性

Association of multimorbidity patterns with activity of daily living and instrumental activity of dai-ly living disability among ≥45 years middle-aged and elderly population in China

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目的 聚类中国≥45岁中老年人多重慢性病模式的流行情况,并探讨多重慢性病模式与日常生活能力(activity of daily living,ADL)和工具性日常生活能力(instrumental activity of daily living,IADL)残疾的关联性.方法 基于2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)数据库,以19 745名≥45岁中老年人为研究对象,采用双向聚类法(two-way clustering framework,TCF)识别非随机多重慢性疾病模式后进行人群聚类,并采用logistic回归分析模型分析多重慢性病模式与ADL和IADL残疾的相互关系.结果 中国中老年人多重慢性病患者例数为10 941,占55.4％,可聚类为心脑血管-代谢模式、呼吸系统-内脏模式和消化-关节-精神模式,根据多重慢性病模式的关联强度将人群划分为5个多重慢性病关联组.其中,高度关联心脑血管-代谢模式和消化-关节-精神模式人群的ADL和IADL残疾负担最重(OR=4.696,95％CI:4.196～5.255,P＜0.001;OR=3.155,95％CI:2.840～3.504,P＜0.001),高度关联心脑血管-代谢模式合并中度关联呼吸系统-内脏模式的人群罹患ADL和IADL残疾的风险次之(OR=2.821,95％CI:2.210～3.602,P＜0.001;OR=2.662,95％CI:2.120～3.342,P＜0.001).结论 中国中老年人群中高度关联心脑血管-代谢模式发生ADL和IADL残疾的风险最高.
Objective To cluster the epidemic situation of multimorbidity patterns in middle-aged and elderly people aged 45 years and above in China,and explore the relationship between multimorbidity patterns and activity of daily living(ADL)/instrumental activity of daily living(IADL)disability.Methods Based on the 2018 China Health and Retirement Longitudinal Study(CHARLS),the study included a total of 19 745 individuals aged 45 years and older from the middle-aged and elderly population.To identify non-random multimorbidity patterns,a two-way clustering framework(TCF)was utilized for clustering people,while logistic regression was employed to analyze the association between multimorbidity patterns and ADL/IADL disability.Results The number of middle-aged and elderly patients with multimorbidity in China was 10 941,accounting for 55.4％of the sample,which could be clustered into three patterns:cardio-cerebrovascular-metabolic pattern,respiratory system-visceral pattern and digestion-articular-mental pattern.According to the association strength of multimorbidity patterns,the population was divided into five multimorbidity association groups.ADL/IADL disability burden was the high-est in people with highly related cardio-cerebrovascular-metabolic pattern and digestion-articular-mental pattern(OR=4.696,95％CI:4.196-5.255,P＜0.001;OR=3.155,95％CI:2.840-3.504,P＜0.001).The risk of ADL/IADL disability in people with highly related cardio-cerebrovascular metabolic pattern and moderate related respiratory system-visceral pattern was the second(OR=2.821,95％CI:2.210-3.602,P＜0.001;OR=2.662,95％CI:2.120-3.342,P＜0.001).Conclusions The risk of ADL/IADL disability is the highest in middle-aged and elderly people with highly related cardio-cerebrovascular metabolic patterns.

MultimorbidityMiddle-aged and elderly adultsActivity of daily livingInstrumental activity of daily livingTwo-way clustering framework

李艳萍、王媛、纪之琳、白婧琰、张岩波、陆姣

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山西医科大学公共卫生学院卫生统计学教研室,太原 030001

山西医科大学管理学院,太原 030001

山西医科大学公共卫生学院社会医学教研室,太原 030001

山西医科大学公共卫生学院统计教研室,重大疾病风险评估山西省重点实验室,太原 030001

西安交通大学公共政策与管理学院,卫生管理与政策研究所,西安 710049

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多重慢性病 中老年人 日常生活能力 工具性日常生活能力 双向聚类法

教育部人文社会科学研究规划基金中国博士后科学基金第15批特别资助项目国家自然科学基金青年项目

22YJA6300592022T15051471804101

2024

10.16462/j.cnki.zhjbkz.2024.01.005

中华疾病控制杂志
中华预防医学会 安徽医科大学

中华疾病控制杂志

CSTPCD北大核心
影响因子：1.862
ISSN：1674-3679
年,卷(期)：2024.28(1)
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