Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-02-19 Cooperative journals: 《中国全科医学》
LIAO Yanming
ZHENG Xiao
XUE Yaqing
XIAO Shujuan
XUE Benli
LI Xinru
CHEN Yiming
ZHANG Mengjie
ZHANG Chichen
Abstract： Background The severe trend of the aging population，the rapid increase in the prevalence of chronic diseases among older adults，and the greater prominence of multimorbidity have posed challenges to the prevention and treatment of chronic diseases in China. Adverse health-related behaviors are modifiable risk factors for chronic diseases. Exploring the latent classes of health-related behaviors in older adults with multimorbidity and their associations with quality of life will help identify the characteristics of their health-related behaviors and uncover risk behaviors affecting the quality of life，providing references for precise health management to improve the quality of life of older adults. Objective This study aimed to explore the latent classes of health-related behaviors in older adults with multimorbidity and the differences in the quality of life among the different classes，to provide references for conducting precise health management to improve the quality of life of older adults. Methods Based on the baseline data from the Community Health and Behavior of the Elderly Panel Study（CHBEPS）conducted by our team，a total of 1，395 older adults aged 60 years and above with multimorbidity were included as study participants. A self designed questionnaire was used to collect basic information，including disease status，smoking status，alcohol consumption，and dietary preferences of the participants. The Pittsburgh Sleep Quality Index（PSQI），International Physical Activity Questionnaire-Short-Chinese Version（IPAQ-S-C），and Lubben Social Network Scale-6（LSNS-6）were used to assess staying up late，physical activity，and social network of the participants，respectively. The EuroQol five-dimensional five-level questionnaire（EQ-5D-5L）was used to measure the quality of life of the participants. Latent class analysis of health-related behaviors among older adults with multimorbidity was conducted using Mplus 8.3 software. Based on the fitted model，the different latent classes of health-related behaviors among older adults with multimorbidity were used as groups，and the Kruskal-Wallis and Wilcoxon rank-sum tests were performed using SPSS 26.0 software to analyze the differences in quality of life among these groups. Results Four latent classes of health-related behaviors were identified among older adults with multimorbidity，which are named the health behavior group，risk behavior group，comprehensive behavior group，and adverse behavior group. There were statistically significant differences in quality of life among the four latent classes（P<0.05）. Specifically，the quality of life in the health behavior group was higher than that in the risk behavior group and adverse behavior group（P<0.05）. Conclusion When implementing precise health management for older adults with multimorbidity，the characteristics of their health-related behaviors should be taken into account. Special attention should be given to those with a higher probability of behaviors such as smoking，alcohol consumption，and a preference for sweet，spicy，and salty tastes，as well as those with a lower probability of behaviors such as a balanced diet，regular consumption of vegetables and fruits，and social networks. Additionally，measures targeted at addressing common issues such as insufficient physical activity should be implemented to improve the effectiveness of health management and the quality of life of older adults with multimorbidity.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-02-19 Cooperative journals: 《中国全科医学》
Abstract： Background Currently，research on the factors influencing the health status of older adults with multimorbidity in China is scattered，and it is difficult to give a comprehensive consideration from a holistic perspective，and the contribution of factors leading to health disparities is not explored，resulting in the ineffectiveness of current health management often programs in older adults with multimorbidity. Objective By introducing a health bifactor model，this study aims to understand the endogenous and exogenous influencing factors and their contributions to the health of older adults with multimorbidity and provide a practical basis for developing precise health management plans for older adults with multimorbidity. Methods In this study，using the China Health and Retirement Longitudinal Survey（CHARLS）2018 data and introducing the two-factor model of health developed from the Grossman health production function（including both endogenous and exogenous aspects of health determinants），first，the Wilcoxon rank sum test was used to analyze whether there were differences in the health status of older adults with multimorbidity by gender，Secondly，the OLS regression model was used to analyze the mechanism of the two-factor model of health on the health of older adults with multimorbidity，Finally，the Shapley value method was further used to decompose the contribution of health endogenous factors to their health. Results The study found that factors such as still drinking alcohol，having no disease control methods，being satisfied with medical services，having a high level of education，having a pension，not using health services，attending free health checks，caring for grandchildren and being satisfied with their children's relationship were more likely to improve the health of older people with multiple chronic conditions. The results of the Shapley decomposition showed that ＂ socioeconomic status ＂ was the most important factor in the full sample，while ＂ family health support ＂＂ health-related behaviors ＂，and ＂ health-related behaviors ＂ were the most important factors. ＂ coping strategies ＂ was the next most important，and ＂ social health resources ＂ was the least influential. In the gender subgroup analysis，socioeconomic status remained the most important factor； for older men with multiple chronic illnesses，health-related behaviors were the next most important factor； for older women with multiple chronic illnesses，coping strategies were the next most important. Conclusion The health status of elderly men with multimorbidity is better than that of women，socioeconomic status is the most important factor affecting the health of older adults with multimorbidity，and the remaining four dimensions have different contributions to the health differences between men and women. It is recommended that precise health management should be implemented according to the size of the contribution of each dimension of different health endogenous factors to improve the health status of older adults with multimorbidity with maximum benefit.
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