Accelerated multimorbidity in early adulthood and long-term functional disability in later life: a life-course epidemiological study.

IF 4.1 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Yushan Du, Xiaohan Zhu, Mingxing Wang, Ziyi Ye, Wen Cui, Chao Guo
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引用次数: 0

Abstract

Background: Chronic somatic diseases (CSDs), particularly cardiometabolic diseases (CMDs) are recognized contributors to functional disability, yet limited evidence examines these associations by employing longitudinal approaches.

Objective: This study aimed to investigate the association between early adulthood patterns of CMDs and other CSDs with the incidence and trajectories of later-life functional disability.

Methods: Data were drawn from the China Health and Retirement Longitudinal Study implemented during 2011-2020. Functional disability was measured by activities of daily living (ADL) and instrumental activities of daily living (IADL). Latent class trajectory modeling was used to identify 10-year trajectories of functional disability. Sequence analysis was used to cluster CSD patterns from ages 18 to 44 and time-dependent Cox proportional hazard models and logistical regressions were employed to detect the associations between early adulthood CSD patterns and the incident risk and longitudinal trajectory of functional disability in later life.

Results: Among 7,077 participants, four distinct early adulthood disease patterns were identified: (I) "Long-term health," (II) "Long-term with a non-CMD CSD", (III) "Later fast transition to CMDs or non-CMD CSDs", and (IV) "Early transition to CMDs or multimorbidity". After adjusting for covariates, participants with a history of CSDs showed higher risks of functional disability.

Conclusion: This study confirms that early adulthood patterns of CSDs are differentially associated with later-life functional disability, through the establishment of a lifespan-based disease-disability research framework and multi-disease trajectory modeling. Early diagnosis and interventions for CSDs are important to sustain functional function in aging.

Clinical trial number: Not applicable.

成年早期加速多病和晚年长期功能残疾:一项生命历程流行病学研究。
背景:慢性躯体疾病(CSDs),特别是心脏代谢疾病(CMDs)被认为是导致功能残疾的因素,但采用纵向方法研究这些关联的证据有限。目的:本研究旨在探讨CMDs和其他CSDs的成年早期模式与后期功能障碍的发生率和发展轨迹之间的关系。方法:数据来自2011-2020年实施的中国健康与退休纵向研究。以日常生活活动(ADL)和工具性日常生活活动(IADL)测量功能障碍。潜在类别轨迹模型用于识别功能性残疾的10年轨迹。采用序列分析对18岁至44岁的CSD模式进行聚类,并采用时间依赖的Cox比例风险模型和逻辑回归来检测成年早期CSD模式与以后生活中发生的事件风险和功能残疾的纵向轨迹之间的关联。结果:在7,077名参与者中,确定了四种不同的成年早期疾病模式:(I)“长期健康”,(II)“长期患有非cmd型CSD”,(III)“后来快速过渡到cmd或非cmd型CSD”,以及(IV)“早期过渡到cmd或多病”。在调整协变量后,有CSDs病史的参与者显示出更高的功能性残疾风险。结论:本研究通过建立基于寿命的疾病-残疾研究框架和多疾病轨迹建模,证实了CSDs的成年早期模式与后期功能残疾存在差异。早期诊断和干预对维持老年人的功能功能至关重要。临床试验号:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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