Association Between Speed of Multimorbidity Accumulation in Old Age and Life Experiences: A Cohort Study

被引:37
作者
Dekhtyar, Serhiy [1 ,2 ]
Vetrano, Davide Liborio [1 ,2 ,3 ,4 ]
Marengoni, Alessandra [1 ,2 ,5 ]
Wang, Hui-Xin [1 ,2 ,6 ]
Pan, Kuan-Yu [1 ,2 ]
Fratiglioni, Laura [1 ,2 ,7 ]
Calderon-Larranaga, Amaia [1 ,2 ]
机构
[1] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Aging Res Ctr, Tomtebodavagen 18A, SE-17165 Stockholm, Sweden
[2] Stockholm Univ, Stockholm, Sweden
[3] Univ Cattolica Sacro Cuore, Dept Geriatr, Rome, Italy
[4] Fdn Policlin A Gemelli, IRCCS, Ctr Med Invecchiamento, Rome, Italy
[5] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy
[6] Stockholm Univ, Stress Res Inst, Stockholm, Sweden
[7] Stockholm Gerontol Res Ctr, Stockholm, Sweden
基金
瑞典研究理事会;
关键词
aging; childhood socioeconomic circumstances; education; life-course; multimorbidity; occupational stress; physical resilience; social networks; CORONARY-HEART-DISEASE; SOCIOECONOMIC-STATUS; PHYSICAL RESILIENCE; PSYCHOSOCIAL STRESS; SOCIAL ENGAGEMENT; JOB STRAIN; HEALTH; TRAJECTORIES; POPULATION; ADULTS;
D O I
10.1093/aje/kwz101
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Rapidly accumulating multiple chronic conditions (multimorbidity) during aging are associated with many adverse outcomes. We explored the association between 4 experiences throughout life-childhood socioeconomic circumstances, early-adulthood education, midlife occupational stress, and late-life social network-and the speed of chronic disease accumulation. We followed 2,589 individuals aged >= 60 years from the Swedish National Study on Aging and Care in Kungsholmen for 9 years (2001-2013). Information on life experiences was collected from detailed life-history interviews. Speed of disease accumulation was operationalized as the change in the count of chronic conditions obtained from clinical examinations, medical histories, laboratory data, drug use, and register linkages over 9 years. Linear mixed models were used to analyze the data. Speed of disease accumulation was lower in individuals with more than elementary education (for secondary, beta x time = -0.065, 95% CI: -0.126, -0.004; for university, beta x time = -0.118, 95% CI: -0.185, -0.050); for active occupations compared with high-strain jobs (beta x time = -0.078, 95% CI: -0.138, -0.017); and for richer social networks (for moderate tertile, beta x time = -0.102, 95% CI: -0.149, -0.055; for highest tertile, beta x time = -0.135, 95% CI: -0.182, -0.088). The association between childhood circumstances and speed of disease accumulation was attenuated by later-life experiences. Diverse experiences throughout life might decelerate chronic disease accumulation during aging.
引用
收藏
页码:1627 / 1636
页数:10
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