泰国中老年人群中功能障碍与多种疾病之间的双向关联。
Bidirectional association between functional disability and multimorbidity among middle-aged and older adults in Thailand.
机构信息
Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
出版信息
Front Public Health. 2022 Dec 5;10:1055699. doi: 10.3389/fpubh.2022.1055699. eCollection 2022.
OBJECTIVES
The purpose of this study was to assess the bidirectional association between multimorbidity (MM) and functional disability among middle-aged and older adults in a longitudinal study in Thailand.
METHODS
We analyzed longitudinal data of participants aged 45 years and older from two consecutive waves (in 2015 and 2017) of the Health, Aging, and Retirement in Thailand (HART). Functional disability was assessed with a 4-item activity of daily living (ADL) scale. Logistic regression analysis was conducted to assess the association between baseline functional disability and incident MM (≥2), and baseline morbidity and incident functional disability.
RESULTS
The results indicate that a total of 1,716 individuals without morbidity at baseline and 3,529 without functional disability at baseline were included. At follow-up, 16.7 and 20.0% of functional disability cases and 7.1 and 3.6% of nonfunctional disability cases developed 2 morbidities and 3 or more morbidities, respectively, and 6.6% of MM cases and 4.0% of non-MM cases developed a functional disability. In the final logistic regression model adjusted for education, income, age, marital status, sex, smoking tobacco, body mass index (BMI), alcohol use, physical activity, and social engagement, functional disability at baseline was positively associated with incident MM (≥2) (adjusted odds ratio [aOR]: 2.58, 95% CI: 1.42-4.72), and MM (≥3) at baseline was positively associated with incident functional disability (aOR: 1.97, 95% CI: 1.13-3.43).
CONCLUSION
Multimorbidity and functional disability were bidirectionally associated.
目的
本研究旨在通过泰国的一项纵向研究评估中老年人多病共存（MM）与功能障碍之间的双向关联。
方法
我们分析了来自泰国健康、老龄化和退休研究（HART）连续两个波次（2015 年和 2017 年）的年龄在 45 岁及以上参与者的纵向数据。功能障碍通过 4 项日常生活活动（ADL）量表进行评估。采用逻辑回归分析评估基线功能障碍与新发 MM（≥2）以及基线发病与新发功能障碍之间的关系。
结果
结果表明，共纳入了 1716 名基线无发病且 3529 名基线无功能障碍的个体。随访时，功能障碍病例中有 16.7%和 20.0%分别发展为 2 种和 3 种及以上发病，而非功能障碍病例中有 7.1%和 3.6%分别发展为 2 种和 3 种及以上发病；MM 病例中有 6.6%和非 MM 病例中有 4.0%分别发展为功能障碍。在调整教育、收入、年龄、婚姻状况、性别、吸烟、体重指数（BMI）、饮酒、体力活动和社会参与度后，最终的逻辑回归模型显示，基线功能障碍与新发 MM（≥2）呈正相关（调整后优势比[aOR]：2.58，95%可信区间[CI]：1.42-4.72），而基线 MM（≥3）与新发功能障碍呈正相关（aOR：1.97，95% CI：1.13-3.43）。
结论
多病共存和功能障碍之间存在双向关联。
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