Chinese General Practice ›› 2023, Vol. 26 ›› Issue (29): 3622-3627.DOI: 10.12114/j.issn.1007-9572.2023.0140

• Monographic Research of Multimorbidity • Previous Articles     Next Articles

Influence of Multimorbidity on Anxiety Symptoms among Chinese Elderly People: a Propensity Score-matched Study

  

  1. Institute for Hospital Management of Tsinghua University/Tsinghua Shenzhen International Graduate School, Shenzhen 518055, China
  • Received:2023-03-05 Revised:2023-04-15 Published:2023-10-15 Online:2023-04-20
  • Contact: ZHANG Dan

慢性病共病对我国老年人焦虑症状的影响研究:基于倾向性评分匹配

  

  1. 518055 广东省深圳市,清华大学医院管理研究院 清华大学深圳国际研究生院
  • 通讯作者: 张丹
  • 作者简介:
    作者贡献:王萧冉、张丹提出主要研究目标,负责研究的构思与设计,研究的实施,撰写论文;王萧冉进行数据的收集与整理,统计学处理,图、表的绘制与展示;张丹进行论文的修订,负责文章的质量控制与审查,对文章整体负责,监督管理。
  • 基金资助:
    国家自然科学基金资助项目(72004112)

Abstract:

Background

In China, as population aging quickens, multimorbidity has become a major public health problem threatening the health of elderly people. Multimorbidity has a negative impact on mental health, but there is a lack of research on its association with anxiety symptoms in elderly people.

Objective

To investigate the influence of multimorbidity on anxiety symptoms among Chinese elderly people, so as to provide references for improving mental health for older people with multimorbidity.

Methods

We selected 6 854 older adults (≥65 years old) from the participants of the Chinese Longitudinal Healthy Longevity Survey 2018 from December 2022 to February 2023. The 7-item Generalized Anxiety Disorder Scale was used to assess symptoms of anxiety. Multimorbidity was defined as having two or more coexisting chronic conditions, while non-multimorbidity was defined as having only one or no chronic condition. Propensity score matching (PSM) was used tomatch individuals with and without multimorbidity. The association of multimorbidity with anxiety symptoms was analyzed by univariate and multivariate Logistic regression analyses.

Results

Among the 6 854 cases, the prevalence of multimorbidity and anxiety symptoms was 38.04% (2 607/6 854), and 10.53% (722/6 854), respectively. There were 4 247 cases (61.96%) without multimorbidity, of whom 2 102 (30.67%) had no chronic disease, and 2 145 (31.29%) had one chronic disease. A total of 2 282 pairs of multimorbidity and non-multimorbidity (4 564 cases altogether) were obtained after matching. Multivariate Logistic regression analysis showed that multimorbidity was the risk factor of anxiety symptoms〔OR=1.399, 95%CI (1.166, 1.679), P<0.001〕. Besides that, gender, ability to perform activities of daily living and receiving a pension were also related to anxiety symptoms (P<0.05). Five hundred and twenty-two pairs (1 044 cases altogether) were obtained after matching the subjects with multimorbidity and those with one chronic disease using PSM, and the analysis found that those with one chronic disease had higher prevalence of anxiety symptoms〔64.76% (215/332) vs 43.12% (307/712) 〕 (P<0.001) .

Conclusion

Compared with their counterparts without multimorbidity, elderly people with multimorbidity had higher risk of anxiety symptoms, so more attentions should be paid to the mental health of these people.

Key words: Anxiety, Chronic disease, Comorbidity, Multimorbidity, Aged, Propensity score matching, Logistic regression

摘要:

背景

随着我国人口老龄化进程的不断加速,慢性病共病成为威胁老年人健康的重大公共卫生问题,对老年人的心理健康产生消极影响。目前尚缺乏关于老年人慢性病共病与焦虑症状的研究。

目的

探讨慢性病共病对我国老年人焦虑症状的影响,为改善慢性病共病老年人心理状况提供参考。

方法

2022年12月—2023年2月,利用中国老年健康影响因素跟踪调查(CLHLS)2018年数据,选取年龄在65岁以上的6 854名老年人为研究对象。采用广泛性焦虑量表(GAD-7)评估老年人焦虑症状。患有2种及以上慢性病的研究对象为慢性病共病,患有1种或无慢性病的研究对象为无慢性病共病。利用倾向性评分匹配法(PSM)将有慢性病共病与无慢性病共病的老年人进行匹配,并进行单因素和多因素Logistic回归分析,探究老年人慢性病共病与焦虑症状的关系。

结果

6 854名研究对象中,慢性病共病的发生率为38.04%(2 607/6 854),焦虑症状的发生率为10.53%(722/6 854)。无慢性病共病者4 247名(61.96%),其中无慢性病者2 102名(30.67%),患有1种慢性病者2 145例(31.29%)。PSM后,共匹配到无慢性病共病和慢性病共病老年人2 282对,共4 564例。多因素Logistic回归分析结果显示,慢性病共病是老年人出现焦虑症状的危险因素〔OR=1.399,95%CI(1.166,1.679),P<0.001〕。此外,性别、日常行为能力、是否领取退休金也是老年人出现焦虑症状的影响因素(P<0.05)。进一步对慢性病共病与仅患1种慢性病的老年人进行PSM匹配,得到慢性病共病与患有1种慢性病老年人共522对、1 044例。结果显示,患有1种慢性病老年人焦虑症状发生率(64.76%,215/332)高于慢性病共病老年人(43.12%,307/712)(P<0.001)。

结论

慢性病共病老年人出现焦虑症状的风险高于非共病老年人,应加强对于慢性病共病老年人心理状况的关注。

关键词: 焦虑, 慢性病, 共病, 多重慢病, 老年人, 倾向性评分匹配, Logistic回归分析