The burden of health conditions for middle-aged and older adults in the United States: disability-adjusted life years
The burden of health conditions for middle-aged and older adults in the United States: disability-adjusted life years
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DOI：
10.1186/s12877-019-1110-6
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发表时间：
2019-04-08
期刊：
影响因子：
4.1
通讯作者：
Peterson, Mark
中科院分区：
文献类型：
--
作者：
McGrath, Ryan;Al Snih, Soham;Peterson, Mark
背景：在美国，许多成年人在健康状况下的寿命更长。了解这些健康状况的残疾调整生命年（DIFE）可能有助于告知医疗保健提供者及其患者，指导健康干预，降低医疗保健成本，提高生活质量，并延长美国老年人的寿命。本研究的目的是确定负担的10个健康状况的全国代表性样本的成年人年龄在50岁及以上的美国。方法：数据从1998-2014波的健康和退休研究进行了分析。在每一波中，参与者指出他们是否被诊断患有以下10种疾病：癌症，慢性阻塞性肺病（COPD），充血性心力衰竭，糖尿病，背痛，高血压，髋关节骨折，心肌梗死，风湿病或关节炎以及中风。计算残疾年数和过早死亡的寿命损失年数。在分析中使用了样本权重，以使残疾调整生命年估计数具有全国代表性。结果：共有30,101名参与者。性别分层的DALY估计值范围为男性4092（髋部骨折）至178,055（高血压），女性13,621（髋部骨折）至200,794（高血压）。加权的总DRDs为：髋部骨折17，660，充血性心力衰竭62，630，心肌梗死64，710，COPD 90，337，中风93，996，癌症142，012，糖尿病117，534，背痛186，586，关节炎333，420，高血压378，849。总的来说，有一个估计1,487,734年的健康生活失去了10个健康状况检查在研究periods.Conclusions：这些健康状况的负担占超过100万年的中年和老年美国人的健康生活失去了超过16年的研究期间。我们的研究结果应用于告知医疗保健提供者，并指导旨在改善中老年健康的健康干预措施。此外，改变卫生政策和资源，以适应残疾调整生命年趋势，可能有助于提高老龄化和长寿期间的生活质量。
Background: Many adults are living longer with health conditions in the United States. Understanding the disability-adjusted life years (DALYs) for such health conditions may help to inform healthcare providers and their patients, guide health interventions, reduce healthcare costs, improve quality of life, and increase longevity for aging Americans. The purpose of this study was to determine the burden of 10 health conditions for a nationally-representative sample of adults aged 50 years and older in the United States.Methods: Data from the 1998-2014 waves of the Health and Retirement Study were analyzed. At each wave, participants indicated if they were diagnosed with the following 10 conditions: cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Years lived with a disability and years of life lost to premature mortality were summed for calculating DALYs. Sample weights were utilized in the analyses to make the DALY estimates nationally-representative. Results for the DALYs were presented in thousands.Results: There were 30,101 participants included. Sex stratified DALY estimates ranged from 4092 (fractured hip)-to-178,055 (hypertension) for men and 13,621 (fractured hip)-to-200,794 (hypertension) for women. The weighted overall DALYs were: 17,660 for hip fractures, 62,630 for congestive heart failure, 64,710 for myocardial infarction, 90,337 for COPD, 93,996 for stroke, 142,012 for cancer, 117,534 for diabetes, 186,586 for back pain, 333,420 for arthritis, and 378,849 for hypertension. In total, there were an estimated 1,487,734 years of healthy life lost from the 10 health conditions examined over the study period.Conclusions: The burden of these health conditions accounted for over a million years of healthy life lost for middle-aged and older Americans over the 16 year study period. Our results should be used to inform healthcare providers and guide health interventions aiming to improve the health of middle-aged and older adults. Moreover, shifting health policy and resources to match DALY trends may help to improve quality of life during aging and longevity.