Gender differences in the Prevalence and Pattern of Disease Combination of Chronic Multimorbidity among Indian Elderly
Gender differences in the Prevalence and Pattern of Disease Combination of Chronic Multimorbidity among Indian Elderly
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DOI：
10.1007/s12126-021-09419-9
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发表时间：
2021-07-15
影响因子：
1.5
通讯作者：
Maurya, Priya
中科院分区：
文献类型：
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作者：
Sharma, Palak;Maurya, Priya
背景印度正在经历巨大的人口和流行病学变化，导致人口老龄化加剧。与此同时，同时患有多种慢性病的人数也将增加。本研究的目的是确定性别差异的最普遍的组合慢性疾病的老年人生活在印度的多发病。本研究还探讨了影响印度老年人多死亡状态的因素。这项研究使用了2011年进行的印度人口老龄化知识库建设（BKPAI）的数据。是否存在多发性骨髓瘤被认为是结果变量。采用双因素和Logistic回归分析老年人多发性脑梗死的发生模式和影响因素。计算了多发病人群中患不同慢性病的相对危险度。还计算了总人口和多发病组中最流行疾病组合的患病率。老年人多发病率为32.96%，女性多发病率为34.69%。多发病人群中最常见的疾病依次为关节炎或风湿病（54.75%）、高血压（45.79%）、全天然牙缺失（32.94%）、白内障（31.34%）、糖尿病（23.01%）和哮喘（21.06%）。多发病组中妇女的关节炎或风湿病、糖尿病和高血压患病率高于同一组中的男子。在多发病组中，痴呆、全天然牙齿脱落、抑郁、脑栓塞、中风或血栓形成和骨质疏松症等疾病的相对风险更高。因此，这些疾病与其他慢性疾病共存的可能性更高。多发病组中最常见的疾病组合是关节炎、风湿病或骨关节炎、高血压和白内障（4.68%）。妇女中这一组合的流行率高于男子（妇女：5.79%，男子：3.30%）。年龄、性别、宗教、财富五分位数、目前工作状况、吸烟、饮酒是老年人多重死亡的重要决定因素。多重死亡是一个新出现的问题，与老龄化密切相关。在疾病的组合和患病率方面存在性别差异。因此，有必要利用针对性别的分析来加强对男女的保健服务，因为男女在保健利用方面有不同的优先事项。基于我们的研究结果的相关影响之一是，研究人员和政策制定者需要共同努力，分别为男性和女性制定有效的干预策略，这将有助于减轻人口中的多重负担。
BackgroundIndia is undergoing a huge demographic and epidemiological change, resulting in an increase in population ageing. With this, the number of people with co-existence of multiple chronic diseases is also set to rise. The present study aims to identify gender differential in the most prevalent combinations of chronic conditions among the elderly living with multimorbidity in India. This study also examines the factors affecting multimorbidity status among the Indian elderly. This study used the data from Building a Knowledge Base on Population Ageing in India (BKPAI), conducted in 2011. The presence or not of multimorbidity was considered as the outcome variable. The bivariate and logistic regression analysis was done to access the pattern and predictors of multimorbidity among the elderly. The relative risk of having different chronic conditions were calculated among the population with multimorbidity. The prevalence of most prevalent disease combinations among the overall population and multimorbidity group was also calculated. The overall prevalence of multimorbidity among the elderly was 32.96% and higher among women (34.69%). The most prevalent diseases among respondents with multimorbidity conditions were arthritis or rheumatism (54.75%), hypertension (45.79%), loss of all-natural teeth (32.94%), cataract (31.34%), diabetes (23.01%) and asthma (21.06%). The prevalence of arthritis or rheumatism, diabetes and hypertension were higher among women in the multimorbidity group than men of the same group. The relative risks for conditions like dementia, loss of all-natural teeth, depression, cerebral embolism, stroke or thrombosis and osteoporosis are higher in the multimorbidity group. Hence these conditions have a higher possibility to co-exist with other chronic conditions. The most prevalent combination of diseases in the multimorbidity group was arthritis, rheumatism or osteoarthritis, hypertension, and cataract (4.68%). The prevalence of this combination is higher among women than men (women: 5.79%, men: 3.30%). Age, gender, religion, wealth quintile, current working status, smoking, alcohol were significant determinants of multimorbidity among the elderly. Multimorbidity is an emerging issue and highly associated with ageing. There lie gender differences in the combination of diseases and their prevalence. Therefore, there is a need to strengthen healthcare services for both men and women using gender-specific analysis as both genders have different priorities regarding healthcare utilisation. One of the relevant implications based on our findings is that researchers and policymakers need to work together to develop effective intervention strategies separately for men and women, which will help to reduce the burden of multimorbidity in the population.