IR@PKUHSC  > 北京大学精神卫生研究所
学科主题精神卫生
Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey
Sousa, Renata M.1; Ferri, Cleusa P.1; Acosta, Daisy2; Albanese, Emiliano1; Guerra, Marietta3; Huang, Yueqin4; Jacob, K. S.5; Jotheeswaran, A. T.6; Llibre Rodriguez, Juan J.7; Rodriguez Pichardo, Guillermina8; Calvo Rodriguez, Marina7; Salas, Aquiles9; Luisa Sosa, Ana10; Williams, Joseph6; Zuniga, Tirso10; Prince, Martin1
刊名LANCET
2009-11-01
374期:9704页:1821-1830
收录类别SCI ; SSCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]ASSESSMENT SCHEDULE-II ; CROSS-SECTIONAL SURVEY ; PSYCHOMETRIC PROPERTIES ; WHODAS-II ; HEALTH ; EPIDEMIOLOGY ; METHODOLOGY ; PREVALENCE ; DEPENDENCY ; DEPRESSION
英文摘要

Background Disability in elderly people in countries with low and middle incomes is little studied; according to Global Burden of Disease estimates, visual impairment is the leading contributor to years lived with disability in this population. We aimed to assess the contribution of physical, mental, and cognitive chronic diseases to disability, and the extent to which sociodemographic and health characteristics account for geographical variation in disability.

Methods We undertook cross-sectional surveys of residents aged older than 65 years (n=15 022) in 11 sites in seven countries with low and middle incomes (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Disability was assessed with the 12-item WHO disability assessment schedule 2.0. Dementia, depression, hypertension, and chronic obstructive pulmonary disease were ascertained by clinical assessment; diabetes, stroke, and heart disease by self-reported diagnosis; and sensory, gastrointestinal, skin, limb, and arthritic disorders by self-reported impairment. Independent contributions to disability scores were assessed by zero-inflated negative binomial regression and Poisson regression to generate population-attributable prevalence fractions (PAPF).

Findings In regions other than rural India and Venezuela, dementia made the largest contribution to disability (median PAPF 25.1% [IQR 19.2-43.6]). Other substantial contributors were stroke (11.4% [1.8-21.4]), limb impairment (10.5% [5.7-33.8]), arthritis (9.9% [3.2-34.8]), depression (8.3% [0.5-23.0]), eyesight problems (6.8% [1.7-17.6]), and gastrointestinal impairments (6.5% [0.3-23.1]). Associations with chronic diseases accounted for around two-thirds of prevalent disability. When zero inflation was taken into account, between-site differences in disability scores were largely attributable to compositional differences in health and sociodemographic characteristics.

Interpretation On the basis of empirical research, dementia, not blindness, is overwhelmingly the most important independent contributor to disability for elderly people in countries with low and middle incomes. Chronic diseases of the brain and mind deserve increased prioritisation. Besides disability, they lead to dependency and present stressful, complex, long-term challenges to carers. Societal costs are enormous.

语种英语
WOS记录号WOS:000272370200027
引用统计
被引频次:156[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/68006
专题北京大学精神卫生研究所
作者单位1.Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China
2.Voluntary Hlth Serv, Dept Community Hlth, Madras, Tamil Nadu, India
3.Med Univ Havana, Fac Med Finlay Albarran, Havana, Cuba
4.Colegio Dominicano Estadist & Demografos, Santo Domingo, Dominican Rep
5.Kings Coll London, Inst Psychiat, Hlth Serv & Populat Res Dept, Ctr Publ Mental Hlth, London SE5 8AF, England
6.Univ Nacl Pedro Henriquez Urena, Dept Internal Med, Geriatr Sect, Santo Domingo, Dominican Rep
7.Natl Inst Mental Hlth Honorio Delgado Hideyo Nogu, Psychogeriatr Unit, Lima, Peru
8.Christian Med Coll & Hosp, Vellore, Tamil Nadu, India
9.Cent Univ Venezuela, Fac Med, Hop Univ Caracas, Dept Med, Caracas, Venezuela
10.Univ Nacl Autonoma Mexico, Natl Inst Neurol & Neurosurg Mexico, Mexico City 04510, DF, Mexico
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GB/T 7714
Sousa, Renata M.,Ferri, Cleusa P.,Acosta, Daisy,et al. Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey[J]. LANCET,2009,374(9704):1821-1830.
APA Sousa, Renata M..,Ferri, Cleusa P..,Acosta, Daisy.,Albanese, Emiliano.,Guerra, Marietta.,...&Prince, Martin.(2009).Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey.LANCET,374(9704),1821-1830.
MLA Sousa, Renata M.,et al."Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey".LANCET 374.9704(2009):1821-1830.
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