Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland
Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland
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DOI：
10.1136/bmjopen-2016-014485
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发表时间：
2017-01-01
期刊：
影响因子：
2.9
通讯作者：
Santos-Eggimann, Brigitte
中科院分区：
文献类型：
--
作者：
Henchoz, Yves;Bula, Christophe;Santos-Eggimann, Brigitte
多次诊断的负担在老年人中有充分的记录，但对慢性症状知之甚少，其中许多症状甚至没有引起医疗注意。本研究旨在确定慢性症状的患病率，它们与基本日常生活活动（BADL）和生活质量（QoL）残疾的关系，以及它们对公共卫生的影响。设计一项基于人群的大型横断面研究。在瑞士法语区的两个地区设置社区。2011年社区居住的68岁及以上老年人（N=5300）。BADL的残疾定义为在穿衣、洗澡、进食、上下床或扶手椅以及使用厕所方面需要困难或帮助。总体生活质量分为有利（即优秀或非常好）或不利（即良好，一般或较差）。被以下14种慢性症状困扰至少6个月：关节痛、背痛、胸痛、呼吸困难、持续咳嗽、腿肿、记忆缺失、注意力难以集中、决策困难、头晕/眩晕、皮肤问题、胃/肠问题、尿失禁和性生活受损。结果只有17.1%的参与者没有报告受到任何这些慢性症状的困扰。加权患病率从3.1%（胸痛）到47.7%（关节痛）不等。大多数慢性症状与BADL或不良生活质量的残疾显著相关，且存在显著的性别差异。慢性症状的数量与BADL的残疾和不良生活质量显著相关，其梯度提示剂量-反应关系。关节疼痛和背部疼痛的人群归因分数最高。慢性症状在老年人中非常普遍，并且与BADL的残疾和不良生活质量相关，特别是当多种慢性症状同时出现时。肌肉骨骼慢性症状对公共卫生的影响很大，因此是预防性干预措施的良好目标。
Objectives The burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact.Design A large cross-sectional population-based study.Setting Community in 2 regions of French-speaking Switzerland.Participants Community-dwelling older adults aged 68years and older in 2011 (N=5300).Outcomes Disability in BADL defined as difficulty or help needed with any of dressing, bathing, eating, getting in/out of bed or an arm chair, and using the toilet. Overall QoL dichotomised as favourable (ie, excellent or very good) or unfavourable (ie, good, fair or poor). Disturbance by any of the following 14 chronic symptoms for at least 6months: joint pain, back pain, chest pain, dyspnoea, persistent cough, swollen legs, memory gaps, difficulty concentrating, difficulty making decisions, dizziness/vertigo, skin problems, stomach/intestine problems, urinary incontinence and impaired sexual life.Results Only 17.1% of participants did not report being disturbed by any of these chronic symptoms. Weighted prevalence ranged from 3.1% (chest pain) to 47.7% (joint pain). Most chronic symptoms were significantly associated with disability in BADL or unfavourable QoL, with substantial gender differences. The number of chronic symptoms was significantly associated with disability in BADL and unfavourable QoL, with gradients suggesting dose-response relationships. Joint pain and back pain had the highest population attributable fractions.Conclusions Chronic symptoms are highly prevalent in older people, and are associated with disability in BADL and unfavourable QoL, particularly when multiple chronic symptoms co-occur. Owing to their high public health impact, musculoskeletal chronic symptoms represent good targets for preventive interventions.