Diabetes multimorbidity combinations and disability in the Mexican Health and Aging Study, 2012-2015.
Diabetes multimorbidity combinations and disability in the Mexican Health and Aging Study, 2012-2015.
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墨西哥健康与老龄化研究中的糖尿病多发病组合和残疾，2012-2015。
DOI：
10.1016/j.archger.2020.104292
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发表时间：
2021-03
影响因子：
4
通讯作者：
García-Peña C
中科院分区：
文献类型：
--
作者：
McClellan SP;Haque K;García-Peña C
本研究的目的是调查墨西哥老年糖尿病患者慢性疾病和残疾的特定组合之间的关系。这是一项针对51岁或以上的墨西哥糖尿病成年人（n=2558）的前瞻性队列研究，使用了2012年和2015年墨西哥健康与老龄化研究的数据。主要结果是测量日常生活活动和工具性日常生活活动能力的指数。主要的独立变量是糖尿病多发病组合，定义为糖尿病和至少一种其他慢性疾病。作者计算了2012年样本中存在的每种多发病组合的患病率，并使用负二项回归模型来估计2015年这些组合中最普遍的组合与残疾发生率的关联。三种最常见的组合是：1）糖尿病-高血压（n=637，31.9%）2）糖尿病-高血压-抑郁（n=388，19.4%）和3）糖尿病-抑郁（n=211，10.6%）。在完全调整的模型中，将特定多项合并症的参与者与单独患有糖尿病的参与者进行比较，与残疾相关性增加的组合是糖尿病-高血压-抑郁症，糖尿病-抑郁症和糖尿病-高血压-关节炎-抑郁症。在嵌套模型中，将关节炎添加到包括抑郁症的组合中增加了这种关联。与先前的研究一致，包括抑郁症在内的多种药物组合与残疾风险增加相关。然而，这种关系的效应量低于国际上先前报道的效应量。这突出表明需要进行面向全球的多形态研究。
The aim of this study was to investigate the relationship between specific combinations of chronic conditions and disability in Mexican older adults with diabetes. This was a prospective cohort study of Mexican adults (n=2558) with diabetes and aged 51 or older that used data from the 2012 and 2015 waves of the Mexican Health and Aging Study. The main outcome was an index that measured ability to perform activities of daily living and instrumental activities of daily living. The main independent variables were diabetes multimorbidity combinations, defined as diabetes and at least one other chronic condition. The authors calculated the prevalence of each multimorbidity combination present in the sample in 2012 and used negative binomial regression models to estimate the association of the most prevalent of these combinations with disability incidence in 2015. The three most prevalent combinations were: 1) diabetes-hypertension (n=637, 31.9%) 2) diabetes-hypertension-depression (n=388, 19.4%) and 3) diabetes-depression (n=211, 10.6%). In fully adjusted models comparing participants with specific multimorbidity combinations to participants with diabetes alone, the combinations that had an increased association with disability were diabetes-hypertension-depression, diabetes-depression and diabetes-hypertension-arthritis-depression. In nested models, the addition of arthritis to combinations including depression increased this association. Consistent with prior studies, multimorbidity combinations including depression were associated with increased risk of disability. However, the effect size of this relationship was lower than what had been previously been reported internationally. This highlights the need for globally oriented multimorbidity research.
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影响因子：
16.2
作者：
Volpato, S;Blaum, C;Guralnik, JM
通讯作者：
Guralnik, JM
影响因子：
6.7
作者：
Jackson, Caroline A.;Jones, Mark;Dobson, Annette
通讯作者：
Dobson, Annette
影响因子：
2.8
作者：
Mejia-Arango, Silvia;Miguel Gutierrez, Luis
通讯作者：
Miguel Gutierrez, Luis
影响因子：
9.3
作者：
Nowakowska, Magdalena;Zghebi, Salwa S.;Kontopantelis, Evangelos
通讯作者：
Kontopantelis, Evangelos
影响因子：
3.4
作者：
Magnan, Elizabeth M.;Bolt, Daniel M.;Smith, Maureen A.
通讯作者：
Smith, Maureen A.