Burden and Patterns of Multimorbidity Impact on Disablement in Older Adults
Burden and Patterns of Multimorbidity Impact on Disablement in Older Adults
复制标题
DOI：
10.1097/phm.0000000000001388
复制
发表时间：
2020-05-01
影响因子：
3
通讯作者：
Bean, Jonathan F.
中科院分区：
文献类型：
--
作者：
Jacob, Mini E.;Ni, Pengsheng;Bean, Jonathan F.
目的本研究的目的是评估多重发病的负担和模式对残疾领域的影响。在一项来自波士顿老年人康复损伤研究的425名老年人的横断面研究中，参与者自我报告了13种慢性疾病，并接受了身体功能评估（腿部力量、速度和力量、躯干伸肌耐力、腿部活动范围、足部感觉）、活动(400米步行测试、短体能性能电池、晚年功能和残疾仪器功能得分)和参与（晚年功能和残疾仪器参与得分）。多病模式（通过潜在分类分析确定）和残疾措施之间的关系，以及多病负担（通过多病评分捕获）和残疾措施之间的关系，进行了测试。结果分类分析确定了低多病、高多病和以肌肉骨骼疾病为主的三种类型。班级成员（多病模式）与残疾措施无关，但多病评分与所有领域的不良表现相关。多病得分每高1分，身体功能（0.06个标准差单位）、活动（0.07-0.10个标准差单位）和参与（0.07-0.09个标准差单位）得分就会降低。结论多重发病计数可作为风险分层和识别需要康复人群的有效工具。在CME上完成自我评估活动和在线评估目标完成本文后，读者应该能够(1)描述和区分多病负担和多病模式对老年人三个残疾领域的影响；(2)确定并讨论高多重疾病负担可能导致老年人社会参与受限的可能原因；(3)通过对老年患者常见慢性病的简单统计，在临床评估中发现老年患者的残疾风险。学术医师协会由继续医学教育认证委员会认证，为医生提供继续医学教育。学术物理医师协会指定该期刊为基础的CME活动，最多可获得1.0 AMA PRA第1类学分（TM）。医生只应要求与他们参与活动的程度相称的荣誉。
ObjectiveThe aim of this study was to assess the impact of the burden and patterns of multimorbidity on disability domains.DesignIn a cross-sectional study of 425 older adults from the Boston Rehabilitative Impairment Study of the Elderly, participants self-reported 13 chronic conditions and underwent assessment of body function (leg strength, velocity, and power, trunk extensor endurance, leg range of motion, foot sensation), activities (400-m walk test, Short Physical Performance Battery, Late Life Function and Disability Instrument function scores) and participation (Late Life Function and Disability Instrument participation scores). The association between multimorbidity patterns (identified by latent class analysis) and disablement measures, as well as multimorbidity burden (captured by a multimorbidity score) and disablement measures, was tested.ResultsLatent class analysis identified three classes-low multimorbidity, high multimorbidity, and predominantly musculoskeletal conditions. Class membership (multimorbidity pattern) was not associated with disablement measures, but multimorbidity score was associated with poor performance in all domains. A 1-point higher multimorbidity score was associated with lower scores in body functions (by 0.06 SD unit), activities (0.07-0.10 SD units), as well as participation (0.07-0.09 units).ConclusionMultimorbidity counts may be an excellent tool for risk stratification and identification of persons in need of rehabilitation.To Claim CME CreditsComplete the self-assessment activity and evaluation online atCME ObjectivesUpon completion of this article, the reader should be able to (1) describe and distinguish the effect of multimorbidity burden and multimorbidity patterns on three disability domains in older adults; (2) identify and discuss possible reasons why high multimorbidity burden may result in a restriction among social participation in older adults; and (3) detect disability risk among older patients during clinical assessment by using a simple count of common chronic conditions.LevelAdvancedAccreditationThe Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)(TM). Physicians should only claim credit commensurate with the extent of their participation in the activity.