背景:全球老年人多发病率的增加是流行病学和人口统计学转变的结果。这项研究的重点是印度这一人口中虚弱的患病率和决定因素,考虑粮食不安全的潜在中介作用。
目的:为了确定患有多种疾病的老年印度成年人中虚弱的患病率和决定因素,并确定粮食不安全对脆弱的中介作用。
方法:队列研究数据的横断面分析。
方法:分析印度纵向老龄化研究(LASI)第1波(2017-2018)的数据。
方法:31,902名年龄在60岁及以上的个体,其中7900人被归类为多发病。
方法:使用改良的Fried量表评估虚弱。关于社会人口因素的细节,生活方式的选择,和健康相关变量通过面对面的参与者访谈收集.多症定义为存在两种或多种慢性疾病,如高血压,糖尿病,癌症,慢性肺病,慢性心脏病,中风,骨病,神经或精神问题,和高胆固醇。使用Stata15.1进行统计分析。
结果:多患病个体虚弱的加权患病率为30.31%(95%CI:28.17,32.54),显著高于没有多发病率的(23.81%,95%CI:22.90,24.74(P<0.001)。在多病患者中,女性的虚弱患病率(33.27%)高于男性(26.56%)。在多患病组中,年龄≥75岁,中间MPCE五分之一,受教育程度较低,失业,低体重指数与较高的虚弱几率相关。中介分析表明,多发病与虚弱之间的关联中有3.47%是由粮食不安全介导的。
结论:虚弱在印度患有多种疾病的老年人中普遍存在,基于性别的巨大差异,年龄,社会经济地位,和体重指数。粮食不安全在一定程度上调解了多发病和虚弱之间的关系,强调需要有针对性的干预措施来解决这一人群的健康和营养不安全问题。
BACKGROUND: The global increase in multimorbidity among older adults is a result of ongoing epidemiological and demographic transitions. This
study focuses on the prevalence and determinants of frailty in this demographic in India, accounting for the potential mediating role of food insecurity.
OBJECTIVE: To determine the prevalence and determinants of frailty among older Indian adults with multimorbidity, and to ascertain the mediating effect of food insecurity on frailty.
METHODS: Cross-sectional analysis of cohort
study data.
METHODS: Analysis of data from the Longitudinal Aging
Study in India (LASI) Wave 1 (2017-2018).
METHODS: 31,902 individuals aged 60 and above of whom 7900 were categorized as having multimorbidity.
METHODS: Frailty was assessed using a modified Fried scale. Details on sociodemographic factors, lifestyle choices, and health-related variables were collected through face-to-face participant interviews. Multimorbidity was defined as the presence of two or more chronic conditions such as hypertension, diabetes, cancer, chronic lung disease, chronic heart disease, stroke, bone disease, neurological or psychiatric problems, and high cholesterol. Statistical analysis was conducted using Stata 15.1.
RESULTS: The weighted prevalence of frailty in individuals with multimorbidity was 30.31% (95% CI: 28.17, 32.54), significantly higher than those without multimorbidity (23.81%, 95% CI: 22.90, 24.74) (P<0.001). Frailty prevalence was higher in women (33.27%) than in men (26.56%) among those with multimorbidity. In the group with multimorbidity, age ≥75 (years), middle MPCE quintile, lower educational attainment, unemployment, and low body mass index was associated with higher odds of frailty. Mediation analysis showed that 3.47% of the association between multimorbidity and frailty was mediated by food insecurity.
CONCLUSIONS: Frailty is prevalent among older adults with multimorbidity in India, with significant disparities based on gender, age, socioeconomic status, and body mass index. Food insecurity partially mediates the relationship between multimorbidity and frailty, highlighting the need for targeted interventions addressing both health and nutritional insecurities in this population.