Association Between Speed of Multimorbidity Accumulation in Old Age and Life Experiences: A Cohort Study
Association Between Speed of Multimorbidity Accumulation in Old Age and Life Experiences: A Cohort Study
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DOI：
10.1093/aje/kwz101
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发表时间：
2019-09-01
影响因子：
5
通讯作者：
Calderon-Larranaga, Amaia
中科院分区：
文献类型：
--
作者：
Dekhtyar, Serhiy;Vetrano, Davide Liborio;Calderon-Larranaga, Amaia
在衰老过程中快速积累的多种慢性疾病（多发病）与许多不良后果有关。我们探索了4种贯穿一生的经历童年社会经济环境、成年早期教育、中年职业压力和晚年社会网络与慢性病积累速度之间的关系。我们对来自瑞典国家Kungsholmen老龄化和护理研究的2，589名年龄≥ 60岁的人进行了为期9年的随访（2001-2013）。生活经验的信息是从详细的生活史访谈中收集的。疾病积累的速度可操作为从临床检查、病史、实验室数据、药物使用和登记联系中获得的慢性疾病计数在9年内的变化。采用线性混合模型对数据进行分析。受教育程度高于初等教育的个体疾病积累速度较低（中学，β x时间=-0.065，95%CI：-0.126，-0.004;大学，β x时间=-0.118，95%CI：-0.185，-0.050）;与高压力工作相比，（beta x时间=-0.078，95% CI：-0.138，-0.017）;对于更丰富的社交网络（对于中等三分位数，β x时间=-0.102，95% CI：-0.149，-0.055;对于最高三分位数，β x时间=-0.135，95% CI：-0.182，-0.088）。童年环境和疾病积累速度之间的关联被晚年经历所削弱。一生中不同的经历可能会减缓衰老过程中慢性疾病的积累。
Rapidly accumulating multiple chronic conditions (multimorbidity) during aging are associated with many adverse outcomes. We explored the association between 4 experiences throughout life-childhood socioeconomic circumstances, early-adulthood education, midlife occupational stress, and late-life social network-and the speed of chronic disease accumulation. We followed 2,589 individuals aged >= 60 years from the Swedish National Study on Aging and Care in Kungsholmen for 9 years (2001-2013). Information on life experiences was collected from detailed life-history interviews. Speed of disease accumulation was operationalized as the change in the count of chronic conditions obtained from clinical examinations, medical histories, laboratory data, drug use, and register linkages over 9 years. Linear mixed models were used to analyze the data. Speed of disease accumulation was lower in individuals with more than elementary education (for secondary, beta x time = -0.065, 95% CI: -0.126, -0.004; for university, beta x time = -0.118, 95% CI: -0.185, -0.050); for active occupations compared with high-strain jobs (beta x time = -0.078, 95% CI: -0.138, -0.017); and for richer social networks (for moderate tertile, beta x time = -0.102, 95% CI: -0.149, -0.055; for highest tertile, beta x time = -0.135, 95% CI: -0.182, -0.088). The association between childhood circumstances and speed of disease accumulation was attenuated by later-life experiences. Diverse experiences throughout life might decelerate chronic disease accumulation during aging.