Gender disparities in physical, psychological, and cognitive multimorbidity among elderly hypertensive populations in rural regions.

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2024-11-22 DOI:10.1186/s12939-024-02324-y
Yudong Miao, Jiajia Zhang, Jian Wu, Dongfang Zhu, Junwen Bai, Jingbao Zhang, Ruizhe Ren, Dan Guo, Mingyue Zhen, Jinxin Cui, Xinran Li, Wenyong Dong, Clifford Silver Tarimo, Yifei Feng, Zhanlei Shen
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Abstract

Background: The prevalence of gender disparities in physical, mental, and cognitive disorders among elderly hypertensive individuals in rural areas remains unclear. This study evaluates these disparities and the factors contributing to multimorbidity in this demographic.

Methods: A face-to-face survey was conducted from July 1 to August 31, 2023, involving the hypertensive population registered with the National Basic Public Health Service Program in Jia County. Physical disorder was defined as having one or more self-reported chronic conditions other than hypertension. Participants experiencing anxiety or depression were as having a psychological disorder. The 9-item Patient Health Questionnaire (PHQ-9) was used to assess depression symptomatology, and anxiety symptoms were evaluated using the 7-item Generalized Anxiety Disorder questionnaire (GAD-7). Cognitive disorders were assessed using the Brief Mental Status Examination Scale (MMSE). Multifactorial logistic regression models were used to analyze factors affecting different disorder combinations in both genders. The net difference in multimorbidity prevalence between genders was determined using the propensity score matching (PSM).

Results: Out of 18,447 hypertensive individuals aged 65 years and above (42.28% men), the prevalence of multimorbidity was 30.64% in men and 38.67% in women. Outcomes included seven categories: physical disorders, psychological disorders, cognitive disorders, and four different combinations of these disorders. The primary outcome was the presence of two or more disorders. The prevalence of physical, psychological, and cognitive disorders and their four combinations were higher in women than in men; Key factors influencing multimorbidity risk included subjective health status, illness duration, medication history, blood pressure control, and lifestyle behaviors in both men and women. Post-PSM analysis revealed that women had a 6.74% higher multimorbidity prevalence than men.

Conclusions: Physical, psychological, and cognitive disorders, along with their various multimorbid combinations, significantly impact the elderly hypertensive population. Prioritizing a healthy lifestyle is essential to mitigate multimorbidity risks. Considering that the prevalence of multimorbidity is higher in women than in men with hypertension, sufficient sleep, maintaining a healthy waist circumference, and medication adherence are vital for managing blood pressure and reducing multimorbidity risks.

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农村地区老年高血压患者在身体、心理和认知多病性方面的性别差异。
背景:农村地区老年高血压患者在身体、精神和认知障碍方面的性别差异仍不清楚。本研究评估了这些差异以及导致该人群多病的因素:于 2023 年 7 月 1 日至 8 月 31 日对郏县国家基本公共卫生服务项目登记的高血压人群进行了面对面调查。躯体疾病是指除高血压外,还患有一种或多种自我报告的慢性疾病。焦虑或抑郁的参与者被视为患有心理障碍。抑郁症状采用 9 项患者健康问卷(PHQ-9)进行评估,焦虑症状采用 7 项广泛性焦虑症问卷(GAD-7)进行评估。认知障碍采用简易精神状态检查量表(MMSE)进行评估。多因素逻辑回归模型用于分析影响男女不同疾病组合的因素。使用倾向得分匹配法(PSM)确定了两性多病患病率的净差异:在 18,447 名 65 岁及以上的高血压患者中(男性占 42.28%),男性的多病患病率为 30.64%,女性为 38.67%。结果包括七个类别:躯体疾病、心理疾病、认知障碍以及这些疾病的四种不同组合。主要结果是存在两种或两种以上疾病。女性躯体疾病、心理疾病和认知障碍及其四种组合的患病率均高于男性;影响多病风险的主要因素包括男性和女性的主观健康状况、病程、用药史、血压控制和生活方式行为。PSM后分析显示,女性的多病症患病率比男性高6.74%:结论:躯体、心理和认知障碍以及各种多病组合对老年高血压患者有重大影响。优先考虑健康的生活方式对于降低多病风险至关重要。考虑到女性高血压患者的多病患病率高于男性,充足的睡眠、保持健康的腰围和坚持服药对于控制血压和降低多病患病风险至关重要。
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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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