目的 探讨健康老龄化指数(healthy aging index,HAI)与中国老年心脏代谢性疾病(cardiometabolic disease,CMD)患者不同共病模式之间的关系,为CMD的防控提供科学依据.方法 数据来源于中国健康与养老追踪调查(CHARLS)项目2011年数据,选取其中1 626名60岁及以上CMD患者为研究对象进行问卷调查和体格检查.运用结构方程模型基于感知能力、认知能力、身体能力、心理能力和活力5个健康老龄化维度构建HAI.采用潜在类别分析(latent class analysis,LCA)确定CMD患者的共病模式类别.采用Stata SE 16.0、Mplus 7.0和AMOS 26.0进行统计分析.采用无序多分类logistic回归模型分析HAI与共病模式之间的关联.结果 1 626名研究对象平均年龄为(68.5±6.9)岁.HAI得分为(5.52±1.64)分,构建出的HAI拟合度较好,适配度(GFI)=0.964,调整后适配度(AGFI)=0.957,标准化均方根残差(SRMR)=0.049.LCA最终确定了 3类CMD共病模式,分别为高血压伴慢性肺部疾病组(n=334),高血压伴风湿或消化系统疾病组(n=635)以及伴高血压组(n=657).无序多分类logistic回归分析结果显示,调整混杂因素后,HAI每增加1分,高血压伴慢性肺部疾病的风险降低28％(OR=0.72,95％CI:0.66～0.80)、高血压伴风湿或消化系统疾病的风险降低23％(OR=0.77,95％CI:0.71～0.84).与HAI低水平组相比,HAI高水平组罹患高血压伴慢性肺部疾病和高血压伴风湿或消化系统疾病的风险分别降低72％(OR=0.28,95％CI:0.19～0.42)和 62％(OR=0.38,95％CI:0.28～0.52).结论 CMD 患者的慢性病共病模式包括高血压伴慢性肺部疾病、高血压伴风湿或消化系统疾病和伴高血压模式.高HAI与CMD患者的高血压伴慢性肺部疾病、高血压伴风湿或消化系统疾病低风险相关.
Correlation between healthy aging index and multimorbidity patterns among older patients with cardiometabolic diseases
Objective To explore the relationship between healthy aging index(HAI)and comorbidity patterns among older adults with cardiometabolic disease(CMD)in China,and provide the scientific basis for CMD prevent and control.Methods The data were from the 2011 data of the China Health and Retirement Longitudinal Study(CHARLS)project,1 626 CMD patients(≥60 years old)were selected as the sujects,the investigation was performed with questionnaire and physical examination.The structural equation model was used to construct HAI based on five healthy aging dimensions(perceptual,cognitive,physical,mental and vitality).Latent class analysis(LCA)was used to determine the comorbidity pattern categories in CMD patients.Stata SE 16.0,Mplus 7.0 and AMOS 26.0 were used to analyze the data.Disordered multi-classification logistic regression model was used to analyze the relstionship between HAI and comorbidity patterns.Results The mean age of 1 626 subjects was(68.5±6.9)years old.The HAI score was(5.52±1.64)scores with a good fit.Good of fit index(GFI)=0.964,adjusted good of fit index(AGFI)=0.957,standardized root mean square residual(SRMR)=0.049.The LCA finally identified that 3 categories of CMD comorbidity patterns were hypertension with chronic lung disease group(n=334),hypertension with rheumatic or digestive diseases group(n=635)and the group with hypertension(n=657),respectively.The unordered multiclassification logistic regression analysis showed that after adjusting for the confounding factors,for each 1-point increase in HAI,the risk of hypertension with chronic lung disease decreased by 28％(OR=0.72,95％CI:0.66-0.80),risk reduction of hypertension with rheumatic or digestive disease by 23％(OR=0.77,95％CI:0.71-0.84).As compared to low HAI level group,the risk of hypertension with chronic lung disease and hypertension with rheumatic or digestive diseases reduced by 72％(OR=0.28,95％CI:0.19-0.42)and 62％(OR=0.38 95％CI:0.28-0.52).Conclusion The chronic comorbidity patterns in CMD patients include hypertension with chronic lung disease,hypertension with rheumatic or digestive disorders,and associated hypertension patterns.High HAI is associated with low risk of hypertension with chronic lung disease,hypertension with rheumatism or digestive disease in patients with CMD.
Healthy agingCardiometabolic diseasePatterns of comorbiditiesCross-section study
NETL
NSTL
万方数据
