Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty
Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty
复制标题
DOI：
10.1186/s12877-018-0928-7
复制
发表时间：
2018-10-04
期刊：
影响因子：
4.1
通讯作者：
Salinas-Rodriguez, Aaron
中科院分区：
文献类型：
--
作者：
Rivera-Almaraz, Ana;Manrique-Espinoza, Betty;Salinas-Rodriguez, Aaron
背景：多发性硬化和虚弱是老年人的相关疾病。越来越多的证据表明，它们与残疾、最差生活质量和死亡等不良健康结果有关。尽管如此，这两种情况的独立协会已经研究，很少有证据表明它们之间的相互作用。我们的目的是评估协会的脆弱性和multimorphies与残疾，生活质量和全因死亡率，以及分析这些conditions.Methods之间的潜在相互作用：分析样本包括1410受访者的残疾和生活质量，和1792死亡率。我们对50岁的墨西哥老年人进行了纵向分析，使用的数据来自世界卫生组织关于全球老龄化和成人健康的第1和第2波研究。使用世界卫生组织残疾评估表（WHODAS 2.0）测量残疾，使用WHOQOL（WHO生活质量）工具测量生活质量。通过审查死亡证明确定全因死亡率。使用线性回归和考克斯比例风险models.Results的协会的脆弱性和multimorbidity残疾，生活质量和死亡率进行了估计：Multimorbidity评估通过三种模式（心肺，血管代谢，精神肌肉骨骼）与本研究中的三个结果。心脏病和精神肌肉骨骼模式增加WHODAS平均评分（分别为β = 5.05; p < 0.01和β = 5.10; p < 0.01），降低WHOQOL评分（分别为β = -1.81; p < 0.01和β = -2.99; p < 0.01）。血管代谢与死亡率（HR = 1.47; p = 0.04）、残疾（β = 3.27; p < 0.01）和生活质量（β = -1.30; p = 0.02）相关。虚弱与死亡率相关（虚弱前：HR =1.48; p = 0.02和虚弱：HR = 1.68; p = 0.03），残疾（虚弱前：β = 5.02; p < 0.01;虚弱：β = 13.29; p < 0.01）和生活质量（虚弱前：β = -2.23; p < 0.01;虚弱：β = -4.38; p < 0.01）。相互作用的脆弱性和多morbiditywere not statistically significant.Conclusions：多morbidity和脆弱性是健康状况不佳的重要预测因素。这些结果突出表明，必须开展健康促进和预防行动，以及针对患有多种疾病和虚弱的老年人的具体干预措施，以避免对健康的有害影响。
Background: Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions.Methods: Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models.Results: Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (beta = 5.05; p < 0.01 and beta = 5.10; p < 0.01, respectively) and decreased WHOQOL score (beta = -1.81; p < 0.01 and beta = -2.99; p < 0.01, respectively). Vascular-metabolic was associated with mortality (HR = 1.47; p = 0.04), disability (beta = 3.27; p < 0.01) and quality of life (beta = -1.30; p = 0.02). Frailty was associated with mortality (pre-frail: HR =1.48; p = 0.02 and frail: HR = 1.68; p = 0.03), disability (pre-frail: beta = 5.02; p < 0.01; frail: beta = 13.29; p < 0.01) and quality of life (pre-frail: beta = -2.23; p < 0.01; frail: beta = -4.38; p < 0.01). Interaction terms of frailty and multimorbidity were not statistically significant.Conclusions: Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided.