Examining the effects of multiple chronic conditions on cognitive decline and potential moderators among older Koreans: Findings from the Korean Longitudinal Study of Ageing 2006-2016
Examining the effects of multiple chronic conditions on cognitive decline and potential moderators among older Koreans: Findings from the Korean Longitudinal Study of Ageing 2006-2016
复制标题
DOI：
10.1016/j.archger.2021.104424
复制
发表时间：
2021-05-24
影响因子：
4
通讯作者：
Cho, Chi C.
中科院分区：
文献类型：
--
作者：
Lee, Yura;Cho, Chi C.
背景：超过一半的韩国老年人患有两种或两种以上的慢性疾病，称为多发性慢性病(MCC)。成功的自我管理(例如，控制饮食、锻炼、服药)对于防止病情恶化或获得更多慢性病至关重要。本研究采用韩国老龄化纵向研究中的6波(2006-2016)研究方法，研究了MCC对每个慢性病组10年间认知功能衰退和危险因素的影响。MCC分为三组：无慢性组(n=831)、慢性组(n=813)和两种以上慢性组(n=554)。采用SAS9.4软件进行线性混合效应模型分析。结果：MCC患者的认知功能减退程度明显高于无慢性病患者和有慢性病患者。在每一组中，不同的因素与认知有关。在那些没有慢性病的人中，年龄、收入、教育程度和功能障碍与认知能力下降有关。在患有一种慢性病的人中，年龄、婚姻状况、工作状况、自我评估的健康状况和关节炎与认知能力下降有关。在患有两种或两种以上慢性病的人中，年龄、收入、婚姻状况和生活安排与认知能力下降有关。所列因素的P值均小于0.05。结论：MCC与认知功能减退显著相关。认知能力下降的风险因素在三个慢性病组中有所不同。针对每个群体的自我管理计划可能是缓解韩国老年人认知衰退的一个有前途的策略。
Background: More than half of older Koreans have two or more chronic conditions, known as multiple chronic conditions (MCC). Successful self-management (e.g., diet control, exercise, taking medications) is critical to prevent worsening of condition or acquisition of additional chronic conditions. This study investigated the effects of MCC on cognitive decline and risk factors in each chronic condition group over a 10-year period.Methods: Six waves (2006-2016) of the Korean Longitudinal Study of Ageing were used, featuring 2,198 older adults who were cognitively healthy at baseline. MCC were categorized into three groups: no chronic condition (n=831), one chronic condition (n=813), and two or more chronic conditions (n=554). Linear mixed-effects model analyses were conducted using SAS 9.4.Results: Individuals with MCC showed greater cognitive decline than those with no or one chronic condition. Different factors were associated with cognition in each group. Among those with no chronic condition, age, income, education, and functional limitation were associated with cognitive decline. Among those with one chronic condition, age, marital status, working status, self-rated health, and arthritis were associated with cognitive decline. Among those with two or more chronic conditions, age, income, marital status, and living arrangement were associated with cognitive decline. Listed factors have p-values less than .05.Conclusions: Findings indicate MCC is significantly related with cognitive decline. Risk factors for cognitive decline differed across three chronic condition groups. Self-management programs that target each group can be a promising strategy to mitigate cognitive decline among older Koreans.