基于潜在类别分析的宁夏回族自治区南部山区农村老年人慢性病共病对日常生活活动能力的影响研究

BackgroundWith the acceleration of population agingchronic disease comorbidities have become a major public health problem threatening the health of the elderly. There is a close correlation between chronic disease comorbidity and activity of daily livingADL. Howeverthere are few studies on the influence of chronic disease comorbidity and comorbidity pattern on ADL. ObjectiveTo understand the impact of chronic disease comorbidity on ADLto provide a reference for improving the quality of life of the elderly. MethodsFrom June to July 2022a multi-stage stratified random cluster sampling method was used to conduct a face-to-face household survey among 20 821 residents in 4 counties of Ningxia Hui AutonomousRegionincluding demographic characteristicschronic diseasesand ADL impairment. In this study4 362 elderly people 60 years were included as subjects. Potential category analysis was used to determine comorbidity patternsand Logistic regression was used to analyze the effects of chronic disease comorbidity and different comorbidity patterns on activities of daily living. ResultsThe prevalence of chronic diseases among the elderly included was 62.52%2 727/4 362the prevalence of comorbidities was 23.75%1 036/4 362the ADL damage rate was 18.36%801/4 362. Five comorbidity patterns were identified based on the latent category analysisnamely the coronary heart disease comorbidity groupthe rheumatoid arthritis comorbidity groupthe diabetes comorbidity groupthe hypertension comorbidity groupand the multisystem disease comorbidity group. Adjusting for factors such as genderageeducational levelmarital statusoccupationannual per capita household incomesmokingalcohol consumptionexercise statusand self-rated health statuselderly people with comorbidity had 1.909 times95%CI=1.581~2.305P<0.05 risk of impaired ADL than those without comorbidityolder adults in the rheumatoid arthritis comorbidity group had a higher risk of impaired ADL than those in the coronary heart disease comorbidity groupOR95%CI=1.8341.245~2.701P<0.05. ConclusionOlder adults with chronic comorbidities have a higher risk of ADL impairment than older adults without chronic comorbidities. There are differences in the risk of ADL impairment among the elderly with different comorbidity patterns of chronic diseases. The risk of ADL impairment in the elderly in the comorbidity group of rheumatoid arthritis is higher than that in the comorbidity group of coronary heart disease. Therefore there is an urgent need to pay more attention to elderly people with chronic disease comorbiditiesappropriate measures should be taken to improve their health and improve their quality of life.