在哥斯达黎加老年人中使用多状态马尔科夫模型评估脆弱过渡中的多病重负
Rafael Ogaz-González1, Postmus D2, Ricardo Escamilla-Santiago3
1National Autonomous University of México, Faculty of Medicine, Department of Public Health, Sixth Floor, Building B, 411A Circuito Escolar, Copilco Universidad, México City, Coyoacán, 04360, México; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
Archives of medical research
|May 15, 2025
概括
多种疾病,多种慢性疾病的存在,显著加快了老年人的脆弱性. 这种情况增加了变得脆弱和死亡的风险,特别是在那些脆弱前的人身上.
科学领域:
- 老年学与公共卫生
- 慢性疾病流行病学 慢性疾病流行病学
- 衰老研究研究 衰老研究
背景情况:
- 非传染性慢性病 (NCD) 的累积是老年人健康下降的主要因素.
- 随着时间的推移,非传染性疾病可以显著影响个体的脆弱状态.
- 了解多病症和脆弱性之间的联系对于老年人健康干预至关重要.
研究的目的:
- 评估多病症对脆弱现象型转变的影响.
- 评估多病症对脆弱性相关死亡风险的影响.
- 分析多种慢性疾病的老年人脆弱状态的纵向变化.
主要方法:
- 利用了哥斯达黎加长寿和健康衰老研究队列 (2005-2010) 的数据.
- 包括2660名60岁及以上的个人.
- 定义多病症是从13种慢性疾病中具有≥3种非传染性疾病,并使用弗里德标准评估脆弱性. 采用基于马尔科夫的多态模型进行5年分析.
主要成果:
- 多种疾病加快过渡到脆弱,导致早期发病大约30个月.
- 患有多病症和脆弱前状态的个体恢复到强壮的可能性较低 (HR:0.73),变得脆弱的风险更高 (HR:1.83).
- 多发病症增加了前脆弱个体 (HR:1.83) 的全因死亡风险,但不是已经脆弱的人 (HR:0.88).
结论:
- 多种疾病是老年人过渡到脆弱和死亡的重要预测因素.
- 多种慢性疾病的存在有利于进展到脆弱的死亡.
- 针对具有多种疾病的脆弱前期个体的干预措施对于减轻死亡风险至关重要.
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