A Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries-Differences by Chronic Disease and Race/Ethnicity.

IF 2.2 3区医学 Q2 GERONTOLOGY Journal of Aging and Health Pub Date : 2024-12-01 Epub Date: 2023-10-25 DOI:10.1177/08982643231210027

Ana R Quiñones, Gail McAvay, Brent Vander Wyk, Ling Han, Corey Nagel, Heather G Allore

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Abstract

Objectives: Quantifying interdependence in multiple patient-centered outcomes is important for understanding health declines among older adults.

Methods: Medicare-linked National Health and Aging Trends Study data (2011-2015) were used to estimate a joint longitudinal logistic regression model of disability in activities of daily living (ADL), fair/poor self-rated health (SRH), and mortality. We calculated personalized concurrent risk (PCR) and typical concurrent risk (TCR) using regression coefficients.

Results: For fair/poor SRH, highest odds were associated with COPD. For mortality, highest odds were associated with dementia, hip fracture, and kidney disease. Dementia and hip fracture were associated with highest odds of ADL disability. Hispanic respondents had highest odds of ADL disability. Hispanic and NH Black respondents had higher odds of fair/poor SRH, ADL disability, and mortality. PCRs/TCRs demonstrated wide variability for respondents with similar sociodemographic-multimorbidity profiles.

Discussion: These findings highlight the variability of personalized risk in examining interdependent outcomes among older adults.

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按慢性病和种族/民族划分的医疗保险受益人残疾、自评健康和死亡率差异的联合模型。

目的：量化以患者为中心的多种结果的相互依赖性对于了解老年人的健康状况下降很重要。方法：使用与医疗保险相关的国家健康和老龄化趋势研究数据（2011-2015）来估计日常生活活动中的残疾（ADL）、一般/较差的自我评定健康（SRH）和死亡率的联合纵向逻辑回归模型。我们使用回归系数计算了个性化并发风险（PCR）和典型并发风险（TCR）。结果：对于一般/较差的SRH，与COPD相关的几率最高。死亡率最高的是痴呆症、髋部骨折和肾脏疾病。痴呆和髋部骨折与ADL残疾的几率最高相关。西班牙裔受访者ADL残疾的几率最高。西班牙裔和NH黑人受访者的SRH、ADL残疾和死亡率较高。PCR/TCR显示，具有相似社会人口多发病特征的受访者具有广泛的变异性。讨论：这些发现突出了在检查老年人相互依赖的结果时个性化风险的可变性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Aging and Health Multiple-

CiteScore

5.60

自引率

3.60%

发文量

113

期刊介绍： The Journal of Aging and Health is an interdisciplinary forum for the presentation of research findings and scholarly exchange in the area of aging and health. Manuscripts are sought that deal with social and behavioral factors related to health and aging. Disciplines represented include the behavioral and social sciences, public health, epidemiology, demography, health services research, nursing, social work, medicine, and related disciplines. Although preference is given to manuscripts presenting the findings of original research, review and methodological pieces will also be considered.