Multimorbidity has become a prominent public health problem in older people in China as the country reached an aging society. Summarizing the studies in multimorbidity in elderly population and analyzing and discussing the coping strategies are of great significance for comprehensive management of this group of people. Herein, we reviewed the latest studies about multimorbidity in older people involving management practice, diagnosis and treatment model, medication strategy, and the building of medical and nursing team and health management system. Besides that, we summarized the following coping strategies: establishing a patient-centered multimorbidity management research program, promoting the application of geriatric multimorbidity assessment tools, conduct research on the common etiology and pathogenesis of comorbidity, developing standardized guidelines/consensuses on multimorbidity management, formulating treatment schemes using the TCM ideas of "treating diseases according to syndrome" and "holistic treatment", Internet technologies and smart wearable devices, and conducting early risk assessment and management of multimorbidity. In addition, we provided a comprehensive outlook on future research directions. All this is aimed at providing a reference for further in-depth research in this field.
Comorbidities are highly prevalent in osteoporosis patients, including endocrine, circulatory, respiratory, urinary, immune, musculoskeletal, and neurological diseases, which may aggravate osteoporosis, increase the risk of osteoporotic fracture, and seriously affect the quality of patient's life, bringing more challenges to associated clinical management, and imposing a heavy burden on the families and society. There is still a lack of studies on comorbidities of osteoporosis, and the existing research strategies are inadequate to support clinicians to carry out comorbidity management in terms of understanding the causes of osteoporosis and associated comorbidities, and delivering interventions for prevention and treatment of both of them. In view of this, it is suggested to use multidisciplinary integrated treatment, and strengthen the understanding of osteoporosis related comorbidities and their pathogenesis. Moreover, the screening for osteoporosis in people with possible osteoporosis risk should be performed as early as possible, and actions should be taken actively to reduce the risk of fracture in those who are found with osteopenia or osteoporosis. Early screening, diagnosis and treatment are necessary to realize the prevention and treatment of osteoporosis and associated comorbidities.
Osteoporosis (OP) and lumbar disc herniation (LDH) are two common orthopedic diseases encountered clinically, which are closely related and often coexisted, causing great suffering to middle-aged and elderly people along with the accelerated process of population aging.
To perform a cross-sectional survey on the prevalence and associated factors of LDH in OP in community-dwelling middle-aged and elderly people in Beijing, providing a reference for clinical prevention and treatment of this disease.
From November 2017 to July 2018, 1 540 residents with complete demographics and bone mass measurement data who lived in 10 communities in Chaoyang District and Fengtai District of Beijing were selected. A survey was conducted with the residents for understanding their data collected on-site, including demographics, fracture history, fall history, history of hereditary disease, bone mineral density, EuroQol Health Utility score, then those with OP were further selected and divided into two groups by the prevalence of LDH. Multivariate Logistic regression analysis was used to explore the influencing factors of LDH in OP.
A total of 521 cases of OP attended the survey, except for one with missing information of LDH, the other 520 cases (80 with LDH, and 440 without LDH) were included for final analysis. Multivariate Logistic regression analysis indicated that after controlling for age and BMI, falls〔OR=1.96, 95%CI (1.02, 3.78) , P=0.044〕, fracture〔OR=1.80, 95%CI (1.04, 3.12) , P=0.035〕and pain/discomfort〔OR=2.43, 95%CI (1.41, 4.18) , P=0.001〕were independently associated with LDH in OP.
The coexistence of LDH and OP was common in this population. Falls, fractures, and pain/discomfort may be influencing factors of LDH in OP.
