Multimorbidity patterns are differentially associated with functional ability and decline in a longitudinal cohort of older women
Multimorbidity patterns are differentially associated with functional ability and decline in a longitudinal cohort of older women
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DOI：
10.1093/ageing/afv095
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发表时间：
2015-09-01
期刊：
影响因子：
6.7
通讯作者：
Dobson, Annette
中科院分区：
文献类型：
--
作者：
Jackson, Caroline A.;Jones, Mark;Dobson, Annette
研究方法：我们纳入了澳大利亚妇女健康纵向研究的7，270名老年队列参与者，他们从2002年到2011年每3年接受一次调查。2002年，我们使用因子分析从31名年龄在76-81岁之间的女性自我报告的慢性疾病中识别出多发病模式。我们应用线性增量模型来解释磨损和相关的多morphine模式的功能能力和下降在随后的调查中，日常生活活动（ADL）和工具性日常生活活动（IADL）的测量。对于每一种模式，我们确定平均ADL和IADL分数的中间和最高的三分之一的因素得分相比，一个参考group.Results：我们确定了三个多morphine模式，标记肌肉骨骼/躯体（MSO），神经/心理健康（NMH）和心血管（CVD）。2005年，NMH、MSO和CVD的高因子评分与平均ADL和IADL评分（功能能力较差）显著高于所有三个因子的低因子评分的参考组。CVD模式与2005年至2011年期间ADL的最大下降相关，而NMH模式与IADL的最大下降相关。结论：不同的多模态模式与功能能力和下降差异相关。鉴于缺乏对多发病模式的研究，未来的研究应寻求评估我们的研究结果在其他人群和环境中的再现性，并调查改善功能下降预测的潜在影响。
Methods: we included 7,270 participants of the older cohort of the Australian Longitudinal Study on Women's Health, who were surveyed every 3 years from 2002 to 2011. We used factor analysis to identify multimorbidity patterns from 31 self-reported chronic conditions among women aged 76-81 in 2002. We applied a linear increments model to account for attrition and related the multimorbidity patterns to functional ability and decline at subsequent surveys, as measured by activities of daily living (ADL) and instrumental activities of daily living (IADL). For each pattern, we determined mean ADL and IADL scores in the middle and highest third of factor score in comparison to a reference group.Results: we identified three multimorbidity patterns, labelled musculoskeletal/somatic (MSO), neurological/mental health (NMH) and cardiovascular (CVD). High factor scores for NMH, MSO and CVD were associated with significantly higher mean ADL and IADL scores (poorer functional ability) in 2005 compared with the reference group of low factor scores for all three factors. The CVD pattern was associated with the greatest decline in ADL between 2005 and 2011, whereas the NMH pattern was associated with the greatest decline in IADL.Conclusions: distinct multimorbidity patterns were differentially associated with functional ability and decline. Given the paucity of studies on multimorbidity patterns, future studies should seek to assess the reproducibility of our findings in other populations and settings, and investigate the potential implications for improved prediction of functional decline.