Journal of comorbidity · 2019
Health behaviour, social support, socio-economic status and the 5-year progression of multimorbidity: Results from the MultiCare Cohort Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Schäfer Ingmar, Hansen Heike, Kaduszkiewicz Hanna, Bickel Horst, Fuchs Angela, Gensichen Jochen, Maier Wolfgang, Riedel-Heller Steffi G, König Hans-Helmut, Dahlhaus Anne, Schön Gerhard, Weyerer Siegfried, Wiese Birgitt, van den Bussche Hendrik, Scherer Martin
Аннотация
BACKGROUND: Multimorbidity in elderly patients is a major challenge for physicians, because of a high prevalence of and associations with many adverse outcomes. However, the mechanisms of progressing multimorbidity are not well-understood. The aim of our study was to determine if the progression of multimorbidity is influenced by health behaviour and social support and to analyse if the patients' socio-economic status had an effect on these prognostic factors.
METHODS: The study was designed as prospective cohort study based on interviews of 158 GPs and 3189 patients randomly selected from GP records (response rate: 46.2%). Patients were aged 65-85 years at recruitment and observed in four waves of data collection (dropout rate: 41.5%). Statistical analyses of the 'hot deck' imputed data included multilevel mixed-effects linear regression allowing for random effects at the study centre and GP practice within study centre level.
RESULTS: Regarding cardiovascular and metabolic diseases, multimorbidity progressed more rapidly in patients who reported less physical activity (ß = -0.28; 95% confidence interval = -0.35 to -0.20), had more tobacco-related pack years (0.15; 0.07-0.22) and consumed less alcohol (-0.21; -0.31 to -0.12) at baseline. Multimorbidity related to psychiatric and pain-related disorders progressed more rapidly if the patients had less perceived social support (-0.31; -0.55 to -0.07) and reported less physical activity (-0.08; -0.15 to -0.02) at baseline. Education and income only slightly modified the effects of these variables.
CONCLUSION: Depending on the multimorbidity cluster, different strategies should be used for slowing down the progression of multimorbidity. Changing lifestyle and increasing social support are beneficial for the entire group of elderly multimorbid patients - regardless of their socio-economic status.
REGISTRATION: ISRCTN89818205.
METHODS: The study was designed as prospective cohort study based on interviews of 158 GPs and 3189 patients randomly selected from GP records (response rate: 46.2%). Patients were aged 65-85 years at recruitment and observed in four waves of data collection (dropout rate: 41.5%). Statistical analyses of the 'hot deck' imputed data included multilevel mixed-effects linear regression allowing for random effects at the study centre and GP practice within study centre level.
RESULTS: Regarding cardiovascular and metabolic diseases, multimorbidity progressed more rapidly in patients who reported less physical activity (ß = -0.28; 95% confidence interval = -0.35 to -0.20), had more tobacco-related pack years (0.15; 0.07-0.22) and consumed less alcohol (-0.21; -0.31 to -0.12) at baseline. Multimorbidity related to psychiatric and pain-related disorders progressed more rapidly if the patients had less perceived social support (-0.31; -0.55 to -0.07) and reported less physical activity (-0.08; -0.15 to -0.02) at baseline. Education and income only slightly modified the effects of these variables.
CONCLUSION: Depending on the multimorbidity cluster, different strategies should be used for slowing down the progression of multimorbidity. Changing lifestyle and increasing social support are beneficial for the entire group of elderly multimorbid patients - regardless of their socio-economic status.
REGISTRATION: ISRCTN89818205.