症状为中老年和老年人提供了超越症状和疾病的日常功能预测信息,特别是那些多病症患者
Geeske Peeters1,2, Cillian Hourican3, Mike Lees3
1Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands.
Age and ageing
|March 2, 2026
概括
在患有多病症的老年人中,症状和征兆显著地解释了功能限制,而不是仅仅是疾病. 以症状为导向的方法对于更好的临床护理和在这一群体中的研究至关重要.
科学领域:
- 老年学是指老年学的学科.
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 传统的以疾病为中心的护理可能会忽视症状对多种慢性疾病患者日常功能的影响.
- 多病症在评估功能限制方面提出了独特的挑战.
- 了解症状,征兆和疾病之间的相互作用对于全面的患者护理至关重要.
研究的目的:
- 调查症状和迹象是否提供了超越多病症老年人疾病诊断的功能限制的见解.
- 量化症状,迹象和疾病所提供的关于功能限制的独特和共享信息.
- 在现有疾病的背景下评估症状和迹象的预测附加值.
主要方法:
- 分析了阿姆斯特丹长度衰老研究 (1995-2022) 的4025名参与者的数据.
- 利用部分信息分解来分析功能限制的变化,由六种症状,五种征兆和八种疾病解释.
- 采用随机森林模型来评估症状,征兆和疾病的预测贡献,特别是在多病症子组中.
主要成果:
- 在总样本中 (59%具有多种疾病),症状,征兆和疾病共同解释了13.3%的功能限制变异性,协同作用是主要驱动因素.
- 在多病症子组中,症状为解释功能限制贡献了35.5%,而症状和疾病显示冗余.
- 将症状添加到基于疾病的预测模型中,在多病症子组中,预测一致性明显提高了110%,而在总样本中,这一比例为58%.
结论:
- 症状和迹象比单独的疾病更有信息,可以解释多病症患者的功能限制.
- 临床护理和研究应采用以症状为导向的方法,以更好地应对多种疾病的老年人功能限制.
- 将症状评估与疾病管理相结合,对于改善功能结果至关重要.
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