The prevalence and social patterning of chronic diseases among older people in a population undergoing health transition. A 10/66 Group cross-sectional population-based survey in the Dominican Republic
The prevalence and social patterning of chronic diseases among older people in a population undergoing health transition. A 10/66 Group cross-sectional population-based survey in the Dominican Republic
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DOI：
10.1186/1471-2458-10-344
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发表时间：
2010-06-16
影响因子：
4.5
通讯作者：
Prince, Martin J.
中科院分区：
文献类型：
--
作者：
Acosta, Daisy;Rottbeck, Ruth;Prince, Martin J.
背景：在低收入和中等收入国家，对慢性病的更多关注很少针对老年人，他们占这些地区所有死亡人数的72%，占与这类疾病有关的所有残疾调整寿命年的14%。方法：对多米尼加共和国圣多明各地区2011名65岁及以上老年人(其中1451人空腹采血)的慢性病诊断、身体损害、危险因素及相关残疾进行一期横断面调查。结果：最常见的疾病诊断为高血压(73.0%)、贫血(35.0%)、糖尿病(17.5%)、抑郁症(13.8%)和痴呆(11.7%)。符合代谢综合征标准的占39.6%。经直接标准化(年龄和性别)后，中风(标准化发病率[SMR]100)和高血压(SMR 108)的患病率与美国国家健康和营养检查调查(NHANES Reference SMR 100)中的患病率相似，而糖尿病(SMR 83)和代谢综合征(SMR 72)的患病率略低。贫血率是美国的三倍(SMR 310)。糖尿病、高血压、血脂异常、肥胖和代谢综合征与富裕程度和女性性别有关。关节炎、贫血、痴呆症和中风与年龄密切相关，这些疾病也是致残的主要独立因素。结论：在多米尼加共和国社会经济地位较低的社区，许多慢性病的患病率与美国相似。随着人口老龄化，与年龄相关的疾病的患病率可能会增加。心血管疾病患病率也有上升的空间，如果正如在其他正在经历流行病学转变的环境中观察到的那样，危险因素的负担转向不太富裕的人。监测慢性病流行率和社会模式的未来趋势可能有助于评估一级和二级预防战略的有效性和公平性。我们的研究提出的具体建议包括确定并针对老年人贫血的原因，以及解决妇女健康方面的不利因素。
Background: Very little of the increased attention towards chronic diseases in countries with low and middle incomes has been directed towards older people, who contribute 72% of all deaths, and 14% of all Disability Adjusted Life Years linked to this group of conditions in those regions. We aimed to study the prevalence of physical, mental and cognitive diseases and impairments among older people in the Dominican Republic, their social patterning, and their relative contributions to disability.Methods: A cross-sectional catchment area one-phase survey of chronic disease diagnoses, physical impairments, risk factors and associated disability among 2011 people aged 65 years and over (of whom 1451 gave fasting blood samples) in Santo Domingo, Dominican Republic.Results: The most prevalent diagnoses were hypertension (73.0%), anaemia (35.0%), diabetes (17.5%), depression (13.8%) and dementia (11.7%), with 39.6% meeting criteria for metabolic syndrome. After direct standardization (for age and sex) the prevalences of stroke (standardized morbidity ratio [SMR] 100) and hypertension (SMR 108) were similar to those in the United States of America National Health and Nutrition Examination Survey (NHANES reference SMR 100), while those of diabetes (SMR 83) and metabolic syndrome (SMR 72) were somewhat lower. Anaemia was three times more common than in the USA (SMR 310). Diabetes, hypertension, dyslipidaemia, obesity and the metabolic syndrome were associated with affluence and female sex. Arthritis, anaemia, dementia and stroke were strongly age-associated and these conditions were also the main independent contributors to disability.Conclusions: The prevalence of many chronic diseases is similar in predominately low socioeconomic status neighbourhoods in the Dominican Republic to that in the USA. Prevalence of age-associated conditions is likely to increase with demographic ageing. There is also scope for increases in cardiovascular disease prevalence, if, as observed in other settings undergoing the epidemiologic transition, the burden of risk factors shifts towards the less affluent. Monitoring future trends in the prevalence and social patterning of chronic diseases may help to assess the effectiveness and equity of primary and secondary prevention strategies. Specific recommendations from our research include identifying and targeting the causes of anaemia among older people, and addressing women's health disadvantages.