在老年痴呆症,癌症或器官衰竭患者中,丧偶后的死亡率和功能
Rebecca Rodin1, Alexander K Smith2, Edie Espejo3
1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA network open
|September 12, 2024
概括
丧偶会增加老年痴呆症或癌症患者的功能衰退和死亡率. 这凸显了严重疾病和功能障碍的人群中寡妇效应的增加.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 寡妇效应,以增加死亡率和配偶死亡后功能下降为特征,在患有癌症,痴呆症或器官衰竭等严重疾病的老年人中可能更为明显.
- 这些人往往高度依赖配偶的支持,但对这些特定人群中丧偶的影响的数据有限.
研究的目的:
- 研究老年人中丧偶与功能变化和死亡率之间的关联,这些老年人被诊断患有痴呆症,癌症或器官衰竭.
主要方法:
- 一项纵向队列研究,利用与医疗保险索赔相关的健康和退休研究 (2008-2018) 的基于人口的,全国代表性的数据.
- 包括65岁以上具有功能障碍 (得分<9/11) 和有或没有癌症,器官衰竭或痴呆症的社区成年人,与寡妇事件相匹配.
- 功能评分 (日常生活活动/日常生活工具活动) 和1年死亡率是主要结局.
主要成果:
- 丧偶与患有癌症 (变化:-1.17分) 和痴呆症 (变化:-1.00分) 的个体的功能显著下降有关,但与器官衰竭无关.
- 在那些患有癌症 (HR: 1.08) 和痴呆症 (HR: 1.14) 的寡妇中,观察到更高的一年死亡风险,但不是器官衰竭.
结论:
- 丧偶与功能衰退的加速以及功能障碍,痴呆症或癌症的老年人死亡率的增加有关.
- 这些发现表明,与这些情况相关的护理人员负担可能会加剧寡妇效应.
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