Global Multimorbidity Patterns: A Cross-Sectional, Population-Based, Multi-Country Study
Global Multimorbidity Patterns: A Cross-Sectional, Population-Based, Multi-Country Study
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DOI：
10.1093/gerona/glv128
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发表时间：
2016-02-01
影响因子：
5.1
通讯作者：
Maria Haro, Josep
中科院分区：
文献类型：
--
作者：
Garin, Noe;Koyanagi, Ai;Maria Haro, Josep
背景资料。由于老年人多发病的高患病率和影响，人口老龄化对保健系统构成了挑战。然而，关于慢性疾病如何在某些多发病模式中出现，人们知之甚少，这可能在几个层面上对公共卫生产生重大影响。我们研究的目的是识别和描述低收入、中等收入和高收入国家的多发病模式。我们分析了欧洲老龄化合作研究项目(芬兰、波兰和西班牙)和世界卫生组织全球老龄化与成人健康研究(中国、加纳、印度、墨西哥、俄罗斯和南非)的数据。这些横断面研究获得了41,909名50岁以上的非住院成年人的数据。探索性因素分析用于检测多发病模式。此外，还进行了调整后的二元Logistic回归分析，以确定社会人口学因素与多发性生殖障碍之间的关系。总体来说，各国的多发病患病率很高。高血压、白内障和关节炎是最常见的并存疾病。每个国家都发现了两到三种多发病模式。在几个国家中发现了几种模式：“心肺”(心绞痛、哮喘和慢性阻塞性肺疾病)、“代谢”(糖尿病、肥胖和高血压)和“精神关节”(关节炎和抑郁症)。在各个国家的老年人中，多病发病率很高，低收入和中等收入国家逐渐接近较富裕国家的数字。在几个国家存在某些多发病模式，这表明共同的潜在致病因素可能起作用。对这些模式的更深入了解可能会导致制定预防行动，以减少其流行率，并产生管理这些并存疾病的新的、全面的方法。
Background. Population ageing challenges health care systems due to the high prevalence and impact of multimorbidity in older adults. However, little is known about how chronic conditions present in certain multimorbidity patterns, which could have great impact on public health at several levels. The aim of our study was to identify and describe multimorbidity patterns in low-, middle-, and high-income countries.Methods. We analyzed data from the Collaborative Research on Ageing in Europe project (Finland, Poland, and Spain) and the World Health Organization's Study on Global Ageing and Adult Health (China, Ghana, India, Mexico, Russia, and South Africa). These cross-sectional studies obtained data from 41,909 noninstitutionalized adults older than 50 years. Exploratory factor analysis was performed to detect multimorbidity patterns. Additional adjusted binary logistic regressions were performed to identify associations between sociodemographic factors and multimorbidity.Results. Overall multimorbidity prevalence was high across countries. Hypertension, cataract, and arthritis were the most prevalent comorbid conditions. Two or three multimorbidity patterns were found per country. Several patterns were identified across several countries: "cardiorespiratory" (angina, asthma, and chronic obstructive pulmonary disease), "metabolic" (diabetes, obesity, and hypertension), and "mentalarticular" (arthritis and depression).Conclusions. A high prevalence of multimorbidity occurs in older adults across countries, with low-and middle-income countries gradually approaching the figures of richer countries. Certain multimorbidity patterns are present in several countries, which suggest that common underlying etiopathogenic factors may play a role. Deeper understanding of these patterns may lead to the development of preventive actions to diminish their prevalence and also give rise to new, comprehensive approaches for the management of these co-occurring conditions.