因子分析法对老年人共病模式的探讨  

Patterns of multimorbidity in hospitalized older adults based on factor analysis

作　　者：张丽[1] 李耘[1] 王洁妤[1] 马丽娜[1] 孙菲[2] 汤哲[2] 陈彪[3] Zhang Li;Li Yun;Wang Jieyu;Ma Lina;Sun Fei;Tang Zhe;Chen Biao(Department of Geriatrics,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Beijing Geriatric Healthcare Center,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Geriatrics,Xuanwu Hospital of Capital Medical University,Beijing Institute of Geriatrics,Clinical Center for Parkinson's Disease,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院老年医学科,北京100053 [2]首都医科大学宣武医院,北京市老年病防治中心,北京100053 [3]首都医科大学宣武医院老年医学科,北京市老年病医疗研究中心,首都医科大学帕金森病临床诊疗与研究中心,北京100053

出　　处：《中华老年医学杂志》2022年第6期720-724,共5页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2020YFC2008604);卫生部公益性行业科研专项基金(201002011)。

摘　　要：目的研究中国老年住院患者可能存在的共病模式。方法调查全国七个城市12家三甲医院老年科60岁及以上的老年患者共4348例,进行老年健康综合评估问卷调查。使用因子分析法进行共病模式的探索,分析南北方共病模式的差异。结果本研究共纳入4348例老年患者,年龄为(74.15±8.01)岁。对4348例老年人进行因子分析,整体人群的相关系数与偏相关系数的比值(KMO)为0.657,累计贡献率为43.97%。因子分析结果显示整体人群主要为以下5个共病模式:代谢模式、肝-肾模式、退行性疾病模式、神经精神模式、痴呆。进一步分南北地区进行因子分析,南方地区住院老年患者的KMO值为0.654,累计贡献率为43.50%。南方地区共病模式与整个人群相似。北方地区住院老年患者的KMO值为0.648,累计贡献率为45.16%,北方地区共病模式以"肝-肾"模式、"代谢性疾病"模式、"肺-痴呆"模式、"退行性疾病"模式、"精神"模式为主。结论南北方地区老年人共病模式不尽相同,应区别化对待,北方地区老年人应更加注意呼吸系统疾病及痴呆的预防及管理,南方地区老年人更加注意退行性疾病的预防管理。根据共病可能的存在方式,对疾病进行早预防是减少老年人共病的方法之一。Objective To explore the multimorbidity patterns in older inpatients adults,and their differences between Northern and Southern China.Methods A total of 4348 elderly patients aged 60 and above from the geriatrics departments of 12 grade A tertiary hospitals in 7 cities in China were investigated.Factor analysis was used to explore the comorbidity patterns and analyze the differences in comorbidity patterns between Southern and Northern China.Results The study population consisted of 4348 patients over the age of 60,with an average age of(74.15±8.01)years.The total sample had a Kaiser-Meyer-Olkin(KMO)sampling adequacy index of 0.657 and a cumulative variance percentage of 43.97%.Factor analysis revealed there were five major multimorbidity patterns in the patients.These were:the metabolic pattern;the liver-kidney pattern;the degenerative pattern;the neuropsychiatric pattern;dementia.Further factor analysis for the South and the North was conducted.Older inpatients in Southern regions had a KMO sampling adequacy index of 0.654 and a cumulative variance percentage of 43.50%.In Southern China,the multimorbidity patterns were similar to the overall patterns.In Northern regions,older inpatients had a KMO sampling adequacy index of 0.648 and a cumulative variance percentage of 45.16%.The liver-kidney pattern,metabolic disease pattern,lung-dementia pattern,degenerative disease pattern,and neuropsychiatric pattern were the main multimorbidity patterns in Northern China.Conclusions Multimorbidity patterns were different between Northern and Southern China and should be differentiated in their management.In the North,older adults should pay more attention to the prevention and management of respiratory system diseases and dementia,while in the South,older adults should pay more attention to the prevention and management of degenerative disease.Early disease prevention based on multimorbidity patterns is one of the approaches to the reduction of chronic diseases in older adults.

关 键 词：老年人 共病 

分 类 号：R195.4[医药卫生—卫生统计学]