Multimorbidity among persons aged 25-64 years: a population-based study of social determinants and all-cause mortality
Multimorbidity among persons aged 25-64 years: a population-based study of social determinants and all-cause mortality
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DOI：
10.1093/pubmed/fdaa209
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发表时间：
2022-03-07
影响因子：
4.4
通讯作者：
Leavey, G.
中科院分区：
文献类型：
--
作者：
Ferry, F. R.;Rosato, M. G.;Leavey, G.
背景：尽管在整个生命周期中，多发性疾病的发病率不断增加，但对年轻人的疾病和危险因素同时发生的情况却知之甚少。这项以人群为基础的研究考察了中青年人群中的多发病、社会决定因素和相关死亡率。方法根据2011年人口普查统计的北爱尔兰25-岁人口(n=878345)进行分析，并对2014年(8659例死亡)进行全因死亡随访。Logistic回归用于检验社会决定因素，COX比例风险模型用于相关死亡率分析。结果多病患病率女性为13.7%，男性为12.7%。包括精神/认知疾病在内的多种疾病与剥夺之间有很强的联系。在未婚人群中，患多种疾病的可能性较小[相对风险比(RRR)=0.92：95%可信区间(CI)=0.88，0.95；女性RRR=0.90：0.87，0.94]。在女性中，农村与较低的身体多发病(RRR=0.92：0.89，0.95)和较高的精神/认知多发病(RRR=1.35：1.12，1.64)相关。所有多病类别都与更高的死亡率相关。结论多发病带来的健康和经济挑战应进一步“上游”解决。未来的多病研究应该包括更年轻的成年人，以便为预防性干预的发展提供信息，并使卫生和社会护理服务更紧密地符合患者的需求。
Background Despite increasing multimorbidity across the lifespan, little is known about the co-occurrence of conditions and risk factors among younger adults. This population-based study examines multimorbidity, social determinants and associated mortality among younger and middle-age adults. Method Analysis was based on the Northern Ireland population aged 25-64 years enumerated in the 2011 Census (n = 878 345), with all-cause mortality follow-up to 2014 (8659 deaths). Logistic regression was used to examine social determinants and Cox proportional hazards models in the analysis of associated mortality. Results Prevalence of multimorbidity was 13.7% in females and 12.7% in males. There was a strong association between multimorbidity that included mental/cognitive illness and deprivation. Among those never married, multimorbid physical conditions were less likely [relative risk ratios (RRR) = 0.92: 95% confidence interval (CI) = 0.88, 0.95 for males; and RRR = 0.90: 0.87, 0.94 for females]. Rurality was associated with lower physical multimorbidity (RRR = 0.92: 0.89, 0.95) but higher mental/cognitive multimorbidity (RRR = 1.35: 1.12, 1.64) among females. All multimorbid categories were associated with elevated risk of mortality. Conclusion The health and economic challenges created by multimorbidity should be addressed further 'upstream'. Future multimorbidity research should include younger adults to inform the development of preventative interventions and align health and social care services more closely with patients' needs.