Comorbidity of five chronic health conditions in elderly community residents: determinants and impact on mortality.
Comorbidity of five chronic health conditions in elderly community residents: determinants and impact on mortality.
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老年社区居民五种慢性健康状况的合并症：决定因素及其对死亡率的影响。
DOI：
10.1093/gerona/55.2.m84
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Guralnik,JM
中科院分区：
文献类型：
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作者：
Fillenbaum,GG;Pieper,CF;Cohen,HJ;Cornoni-Huntley,JC;Guralnik,JM
背景：合并症在老年人中很常见。其程度、相关性以及对代表性社区居民的生命威胁影响尚不清楚。方法：在1986-87年和1992-93年期间，每年获得医生诊断的冠状动脉疾病（CAD）、脑血管疾病（CVD）、糖尿病和癌症的自我报告信息，每三年从DukeEstablishedPopulationsforEpidemiologicStudies of the Elderly的参与者中获得高血压信息，经验证的多阶段样本包括4，126名65-100岁的黑人和白色社区居民，居住在北卡罗来纳州的五个县的地区。死亡日期是从通过检索国家死亡索引确定的死亡证明中获得的。统计方法包括连续统计、逻辑回归和生存分析。研究结果：在这个样本中，57%的人报告了高血压，20%的人报告了糖尿病，15%的人报告了CAD，9%的人报告了癌症，9%的人报告了CVD; 29%的人没有报告这些疾病，而29%的人报告了两种或更多种疾病。人口统计学特征与CVD或癌症的合并症无关。加强教育往往具有保护作用。年龄、性别和种族的影响因条件而异。在基线时，高血压、CAD、CVD和糖尿病之间存在实质性的共病，但与癌症无关。高血压、心血管疾病和糖尿病是冠心病的危险因素，而糖尿病是心血管疾病的危险因素。在控制了人口统计学特征后，除了高血压以外，所有健康状况都是6年死亡率的预测因素，合并症也是如此。结论：在患有高血压、冠心病、心血管疾病或糖尿病的老年人中发现了显著的合并症;在患有高血压、心血管疾病和糖尿病的老年人中，发现了发生合并症，尤其是冠心病的特殊风险;在患有糖尿病的老年人中，发现了发生心血管疾病的风险。除高血压外，这些疾病及其合并症本身都是危及生命的。
BACKGROUND: Comorbidity is common in elderly persons. Its extent,correlates, and life-threatening impact in representative communityresidents are unclear. METHODS: Self-reported information of physician-diagnosed coronary artery disease (CAD), cerebrovascular disease (CVD),diabetes, and cancer was obtained annually between 1986-87 and 1992-93, andhypertension was obtained triennially from the participants of the DukeEstablished Populations for Epidemiologic Studies of the Elderly, astratified multistage sample of 4,126 Black and White community residentsaged 65-100, living in a five-county area of North Carolina. Date of deathwas obtained from death certificates identified through search of theNational Death Index. Statistical procedures included descriptivestatistics, logistic regression, and survival analysis. RESULTS: Of thissample, 57% reported hypertension, 20% diabetes, 15% CAD, 9% cancer, and 9%CVD; 29% reported none of these conditions, whereas 29% reported two ormore. Demographic characteristics were not related to comorbidity with CVDor cancer. Increased education tended to be protective. The effect of age,gender, and race varied with condition. At baseline there was substantialcomorbidity among hypertension, CAD, CVD, and diabetes, but not withcancer. Hypertension, CVD, and diabetes were risk factors for CAD, whereasdiabetes was a risk factor for CVD. After controlling for demographiccharacteristics, all health conditions except hypertension were predictiveof 6-year mortality, as was the presence of comorbidity. CONCLUSION: Wefound significant comorbidity in older persons who have hypertension, CAD,CVD, or diabetes; particular risk of developing comorbidity, particularlyCAD, among those with hypertension, CVD, and diabetes; and risk of CVD inthose with diabetes. With the exception of hypertension, these conditions,and comorbidity per se, are life- threatening.