Contribution of Chronic Disease to the Burden of Disability
Contribution of Chronic Disease to the Burden of Disability
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DOI：
10.1371/journal.pone.0025325
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发表时间：
2011-09-22
期刊：
影响因子：
3.7
通讯作者：
Mackenbach, Johan P.
中科院分区：
文献类型：
--
作者：
Klijs, Bart;Nusselder, Wilma J.;Mackenbach, Johan P.
背景资料：人口老龄化预计将导致患有一种或多种残疾的人数大幅增加，这可能导致生活质量大幅下降。为了减轻残疾负担并防止生活质量随之下降，首要步骤之一是确定哪些疾病是造成负担的最主要原因。因此，本文的目的是确定特定疾病的残疾患病率和残疾年的贡献，并评估是否大的贡献是由于高疾病患病率或高致残impact.Methodology/主要结果：数据从荷兰的POLS调查（永久Onderzoek Leefsituitary，2001-2007）进行了分析。使用添加剂回归和占共发病率，选定的慢性疾病的致残影响进行了计算，并与ADL和移动性残疾的患病率和年生活被划分为特定疾病的贡献。肌肉骨骼和心血管疾病是造成残疾的主要原因，但慢性非特异性肺病（男性）和糖尿病（女性）也是主要原因。在肌肉骨骼和心血管疾病组中，背痛、外周血管疾病和中风尤其是由于其高度致残影响。关节炎和心脏病的致残率较低，但由于患病率高，致残率也很高。80岁以上的老年人中疾病的致残影响特别高。结论/意义：为了减轻残疾负担，应减少背痛、周围血管疾病和中风等疾病导致残疾的程度，特别是在高龄老年人中。但也应该针对高患病率的中度致残性疾病，如关节炎和心脏病。
Background: Population ageing is expected to lead to strong increases in the number of persons with one or more disabilities, which may result in substantial declines in the quality of life. To reduce the burden of disability and to prevent concomitant declines in the quality of life, one of the first steps is to establish which diseases contribute most to the burden. Therefore, this paper aims to determine the contribution of specific diseases to the prevalence of disability and to years lived with disability, and to assess whether large contributions are due to a high disease prevalence or a high disabling impact.Methodology/Principal Findings: Data from the Dutch POLS-survey (Permanent Onderzoek Leefsituatie, 2001-2007) were analyzed. Using additive regression and accounting for co-morbidity, the disabling impact of selected chronic diseases was calculated, and the prevalence and years lived with ADL and mobility disabilities were partitioned into contributions of specific disease. Musculoskeletal and cardiovascular disease contributed most to the burden of disability, but chronic nonspecific lung disease (males) and diabetes (females) also contributed much. Within the musculoskeletal and cardiovascular disease groups, back pain, peripheral vascular disease and stroke contributed particularly by their high disabling impact. Arthritis and heart disease were less disabling but contributed substantially because of their high prevalence. The disabling impact of diseases was particularly high among persons older than 80.Conclusions/Significance: To reduce the burden of disability, the extent diseases such as back pain, peripheral vascular disease and stroke lead to disability should be reduced, particularly among the oldest old. But also moderately disabling diseases with a high prevalence, such as arthritis and heart disease, should be targeted.