Multimorbidity patterns and their relationship to mortality in the US older adult population.
Multimorbidity patterns and their relationship to mortality in the US older adult population.
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DOI：
10.1371/journal.pone.0245053
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Lee DJ
中科院分区：
文献类型：
--
作者：
Zheng DD;Loewenstein DA;Christ SL;Feaster DJ;Lam BL;McCollister KE;Curiel-Cid RE;Lee DJ
了解美国老年人的多发病模式及其与死亡率的关系对于减少医疗保健利用和改善健康状况非常重要。以前的调查测量多发病的条件计数，而不是条件的具体组合。这项纵向死亡率随访的横断面研究采用潜在类别分析（LCA），以开发具有临床意义的50岁及以上参与者亚组，这些参与者具有2002-2014年国家健康访谈调查中13种慢性病的不同组合。截至2015年12月，对166，126名参与者进行了死亡率与国家死亡指数的联系。进行生存分析以评估LCA分类与全因死亡率和特定原因死亡率之间的关系。LCA确定了五个具有主要特征的多发病组：“健康”（51.5%）、“与年龄相关的慢性疾病”（33.6%）、“呼吸系统疾病”（7.3%）、“认知受损”（4.3%）和“复杂的心脏代谢”（3.2%）。协变量校正生存分析表明，“复杂心脏代谢”类别的死亡率最高，风险比（HR）为5.30，99.5% CI [4.52，6.22];其次是“认知受损”类别（3.34 [2.93，3.81]）;“呼吸系统疾病”分类（2.14 [1.87，2.46]）;和“年龄相关慢性疾病”分类（1.81 [1.66，1.98]）。多死因分类模式与主要潜在死因密切相关。与“呼吸系统疾病”类别相比，“认知受损”类别报告的疾病数量相似，但死亡率显著更高（3.8 vs 3.7种疾病，HR = 1.56 [1.32，1.85]）。我们证明LCA方法是有效的，在临床上有意义的多原发性肝癌亚组的分类。包括认知障碍和抑郁症状在内的特定疾病组合对老年人的死亡率有重大不利影响。老年人经历的慢性病的数量并不总是与死亡风险成比例。我们的研究结果为识别患有多发性硬化症的高危老年人提供了有价值的信息，以促进早期干预治疗慢性疾病并降低死亡率。
Understanding patterns of multimorbidity in the US older adult population and their relationship with mortality is important for reducing healthcare utilization and improving health. Previous investigations measured multimorbidity as counts of conditions rather than specific combination of conditions. This cross-sectional study with longitudinal mortality follow-up employed latent class analysis (LCA) to develop clinically meaningful subgroups of participants aged 50 and older with different combinations of 13 chronic conditions from the National Health Interview Survey 2002–2014. Mortality linkage with National Death Index was performed through December 2015 for 166,126 participants. Survival analyses were conducted to assess the relationships between LCA classes and all-cause mortality and cause specific mortalities. LCA identified five multimorbidity groups with primary characteristics: “healthy” (51.5%), “age-associated chronic conditions” (33.6%), “respiratory conditions” (7.3%), “cognitively impaired” (4.3%) and “complex cardiometabolic” (3.2%). Covariate-adjusted survival analysis indicated “complex cardiometabolic” class had the highest mortality with a Hazard Ratio (HR) of 5.30, 99.5% CI [4.52, 6.22]; followed by “cognitively impaired” class (3.34 [2.93, 3.81]); “respiratory condition” class (2.14 [1.87, 2.46]); and “age-associated chronic conditions” class (1.81 [1.66, 1.98]). Patterns of multimorbidity classes were strongly associated with the primary underlying cause of death. The “cognitively impaired” class reported similar number of conditions compared to the “respiratory condition” class but had significantly higher mortality (3.8 vs 3.7 conditions, HR = 1.56 [1.32, 1.85]). We demonstrated that LCA method is effective in classifying clinically meaningful multimorbidity subgroup. Specific combinations of conditions including cognitive impairment and depressive symptoms have a substantial detrimental impact on the mortality of older adults. The numbers of chronic conditions experienced by older adults is not always proportional to mortality risk. Our findings provide valuable information for identifying high risk older adults with multimorbidity to facilitate early intervention to treat chronic conditions and reduce mortality.
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DOI：
10.1016/j.jamda.2015.07.014
发表时间：
2015-11-01
影响因子：
7.6
作者：
Ahmadi SF;Streja E;Zahmatkesh G;Streja D;Kashyap M;Moradi H;Molnar MZ;Reddy U;Amin AN;Kovesdy CP;Kalantar-Zadeh K
通讯作者：
Kalantar-Zadeh K
影响因子：
2
作者：
BOTMAN, SL;JACK, SS
通讯作者：
JACK, SS
美国国家健康访谈调查，1997- 2015年，种族/族裔群体之间自我报告的认知障碍。
影响因子：
5.5
作者：
Luo H;Yu G;Wu B
通讯作者：
Wu B
影响因子：
3.7
作者：
Boyle PA;Yu L;Wilson RS;Gamble K;Buchman AS;Bennett DA
通讯作者：
Bennett DA
DOI：
10.1080/10705511.2014.935844
发表时间：
2015-04-03
影响因子：
6
作者：
Asparouhov, Tihomir;Muthen, Bengt
通讯作者：
Muthen, Bengt