多种疾病对55岁及以上成年人健康相关生活质量的影响：SU.VI.MAX 2队列研究结果
Effect of Multimorbidity on Health-Related Quality of Life in Adults Aged 55 Years or Older: Results from the SU.VI.MAX 2 Cohort.
作者信息
Walker Valentin, Perret-Guillaume Christine, Kesse-Guyot Emmanuelle, Agrinier Nelly, Hercberg Serge, Galan Pilar, Assmann Karen E, Briançon Serge, Rotonda Christine
机构信息
EA4360 APEMAC, University of Lorraine, University Paris Descartes, Nancy, France.
Department of Gerontology, CHRU de Brabois, Nancy, France.
出版信息
PLoS One. 2016 Dec 29;11(12):e0169282. doi: 10.1371/journal.pone.0169282. eCollection 2016.
INTRODUCTION
Multimorbid chronic diseases are usually considered separately in trials. Here, we aimed to describe overall multimorbidity patterns in adults aged 55 years or older and assess their effect on health-related quality of life (HRQoL).
METHODS
We used data for 5,647 participants included in the SUpplémentation en VItamines et Minéraux AntioXydants 2 (SU.VI.MAX 2) population-based trial. HRQoL was assessed by the French versions of the Medical Outcome Study Short Form 36 and the Duke Health Profile. An exploratory factor analysis was used to determine multimorbidity patterns, and a multimorbidity score for each resulting pattern was calculated. Adjusted multiple linear regression was used to examine the association between the identified multimorbidity and HRQoL scores by gender and for each age group (55-59, 60-64, 65-69, ≥ 70 years).
RESULTS
More than 63% of the sample reported two or more chronic conditions (from 55.8% for those 55-59 years to 74.4% for those ≥ 70 years). Multimorbidity was more common among women than men (67.3% vs 60%). Two different multimorbidity patterns were identified. Pattern A was represented mainly by mental illness and bone impairments. Pattern B was represented mainly by cardiovascular and metabolic disorders. After adjusting for covariates, a high pattern A score was associated with reduced HRQoL for the physical and mental components of each HRQoL questionnaire, and a high pattern B score was associated with reduced HRQoL for only the physical component of each questionnaire. These multimorbidity scores affected HRQoL differently by age group.
CONCLUSION
Our study used a novel methodological approach to account for multimorbidity patterns in determining the link with chronic conditions. These multimorbidity scores (counted and weighted) can be used in clinical research to control for the effect of multimorbidity on patients' HRQoL and may be useful for clinical practice.
CLINICAL TRIAL REGISTRATION
Clinicaltrial.gov (number NCT00272428).
引言
在试验中，多种慢性疾病通常被分开考虑。在此，我们旨在描述55岁及以上成年人的总体多病共存模式，并评估其对健康相关生活质量（HRQoL）的影响。
方法
我们使用了抗氧化维生素和矿物质补充剂2（SU.VI.MAX 2）基于人群的试验中5647名参与者的数据。HRQoL通过医学结局研究简明健康调查36项量表（Medical Outcome Study Short Form 36）和杜克健康概况（Duke Health Profile）的法语版本进行评估。采用探索性因素分析来确定多病共存模式，并计算每种模式的多病共存得分。使用调整后的多元线性回归，按性别和每个年龄组（55 - 59岁、60 - 64岁、65 - 69岁、≥70岁）来检验所确定的多病共存与HRQoL得分之间的关联。
结果
超过63%的样本报告患有两种或更多慢性疾病（55 - 59岁人群中为55.8%，≥70岁人群中为74.4%）。多病共存在女性中比男性更常见（67.3%对60%）。确定了两种不同的多病共存模式。模式A主要以精神疾病和骨骼损伤为特征。模式B主要以心血管和代谢紊乱为特征。在对协变量进行调整后，模式A的高分与每种HRQoL问卷的身体和心理成分的HRQoL降低相关，模式B的高分仅与每种问卷的身体成分的HRQoL降低相关。这些多病共存得分对HRQoL的影响因年龄组而异。
结论
我们的研究采用了一种新颖的方法来考虑多病共存模式，以确定其与慢性疾病的关联。这些多病共存得分（计数和加权）可用于临床研究，以控制多病共存对患者HRQoL的影响，可能对临床实践也有用。
临床试验注册
Clinicaltrial.gov（编号NCT00272428）
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