Associations between complex multimorbidity, activities of daily living and mortality among older Norwegians. A prospective cohort study: the HUNT Study, Norway
Associations between complex multimorbidity, activities of daily living and mortality among older Norwegians. A prospective cohort study: the HUNT Study, Norway
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DOI：
10.1186/s12877-020-1425-3
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发表时间：
2020-01-21
期刊：
影响因子：
4.1
通讯作者：
Krokstad, Steinar
中科院分区：
文献类型：
--
作者：
Storeng, Siri H.;Vinjerui, Kristin H.;Krokstad, Steinar
随着年龄的增长，患有多种慢性疾病是常态。研究疾病的共存如何影响老年人的功能和死亡率具有重要意义。复杂多病可定义为影响至少三个不同器官系统的三种或三种以上的病症。本研究的目的是调查复杂的多病如何影响挪威老年人的日常生活活动和死亡率。方法受试者为1995-1997年Nord-Trondelag健康研究（HUNT2）的60-69岁基线年龄（n = 9058）。采用多项逻辑回归模型研究HUNT2复杂多发病、HUNT3日常生活基本活动和工具活动（2006-2008）与随访期间死亡率之间的关系（n = 5819/5836）。报告风险比（RR）和风险差异（RD），以百分点（pp）为单位，95%置信区间（CI）。结果47.8%的60-69岁患者在基线时符合复杂多病标准（HUNT2）。复杂的多重疾病与11年后HUNT3对IADL辅助的需求密切相关(RR = 1.80 (1.58-2.04), RD = 8.7 (6.8-10.5) pp)，与随访期间的死亡率中度相关(RR = 1.22 （1.12-1.33), RD = 5.1 (2.9-7.3) pp）。复杂多病与11年后基本日常生活活动的相关性较小(RR = 1.24 （0.85-1.83), RD = 0.4 (- 0.3-1.1) pp）。结论：这是首次发现复杂多发病与日常生活活动之间存在关联的研究。复杂的多重疾病应该得到更多的关注，以防止老年人今后残疾。
Background With increasing age, having multiple chronic conditions is the norm. It is of importance to study how co-existence of diseases affects functioning and mortality among older persons. Complex multimorbidity may be defined as three or more conditions affecting at least three different organ systems. The aim of this study was to investigate how complex multimorbidity affects activities of daily living and mortality amongst older Norwegians. Methods Participants were 60-69-year-olds at baseline in the Nord-Trondelag Health Study 1995-1997 (HUNT2) n = 9058. Multinomial logistic regression models were used to investigate the association between complex multimorbidity in HUNT2, basic and instrumental activities of daily living in HUNT3 (2006-2008) and mortality during follow-up (n = 5819/5836). Risk ratios (RR) and risk differences (RD) in percentage points (pp) with 95% confidence intervals (CI) were reported. Results 47.8% of 60-69-year-olds met the criteria of complex multimorbidity at baseline (HUNT2). Having complex multimorbidity was strongly associated with the need for assistance in IADL in HUNT3 11 years later (RR = 1.80 (1.58-2.04) and RD = 8.7 (6.8-10.5) pp) and moderately associated with mortality during the follow-up time (RR = 1.22 (1.12-1.33) and RD = 5.1 (2.9-7.3) pp). Complex multimorbidity was to a lesser extent associated with basic activities of daily living 11 years later (RR = 1.24 (0.85-1.83) and RD = 0.4 (- 0.3-1.1) pp). Conclusions This is the first study to show an association between complex multimorbidity and activities of daily living. Complex multimorbidity should receive more attention in order to prevent future disability amongst older persons.