Multimorbidity

多重发病

• 批准号: 9278789
• 负责人: JOSHUA A SALOMON
• 金额: $ 7.94万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9278789
• 关键词: Activities of Daily Living; Affect; Africa; Africa South of the Sahara; Age; Aging; Alzheimer' s Disease; Chronic; Chronic Disease; Cohort Studies; Communicable Diseases; Communities; Community Health Systems; Complex; Country; Dementia; Diagnosis; Diffuse; Disease; Economics; Epidemiology; Excess Mortality; Gap Junctions; Goals; HIV; HIV Infections; Health; Health Planning; Health Services Needs; Health Status Indicators; Health Transition; Health system; Healthcare; Healthcare Systems; High Prevalence; Hospitalization; Incidence; Income; Individual; Internet; Investigation; Life Expectancy; Link; Longevity; Longitudinal Studies; Measures; Mediating; Mental Health; Morbidity - disease rate; Outcome; Pattern; Phase; Phenotype; Physical Function; Policy Maker; Population; Portraits; Prevalence; Provider; Records; Research; Research Personnel; Resources; Risk; Role; Socioeconomic Status; South African; Sum; Vulnerable Populations; Well in self; aging population; antiretroviral therapy; cognitive function; cohort; cost; falls; frailty; functional status; health care service utilization; health service use; informal care; interest; lens; mental function; mortality; multiple chronic conditions; programs; sex; social; survivorship; trend

Project 5: Multimorbidity—Abstract There is considerable interest in understanding patterns, determinants and consequences of multimorbidity in aging populations, but relatively little research has been conducted outside of high-income settings. The population of sub-Saharan Africa is aging rapidly, resulting in a rising burden of multiple chronic conditions, with additional complexity derived from the high prevalence of HIV infection, especially in the era of increasing survivorship through antiretroviral therapy. As the population ages, conditions affecting cognitive function, notably Alzheimer's disease and related dementias, contribute further to a complex profile of multimorbidity. Multimorbidity likely has significant implications for physical and cognitive functioning, mental health, mortality risks, health service utilization and costs. The concept of frailty has been advanced as a way to characterize a consistent aging phenotype that combines indicators of health and functional status that are highly predictive of health decline and mortality, and the connection between multimorbidity and frailty is important to understand in organizing health systems and planning for both formal and informal care of aging populations. This project uses multimorbidity as an integrative lens through which to unify many of the major empirical observations in the study cohort, and to amplify important themes relating to social and economic drivers of health outcomes in aging populations that link all of the projects in the program. Our overall goal is to illuminate the role of multimorbidity at the nexus of a complex web of determinants, outcomes and consequences. Toward this end the project has four specific aims: AIM 1: Develop a comprehensive portrait of the epidemiology of multimorbidity in a cohort of older South Africans, including its prevalence and degree, its incidence and trajectory, and its patterns and determinants. AIM 2: Evaluate the consequences of multimorbidity on mortality, physical and mental function, and well- being. AIM 3: Assess the implications of multimorbidity for healthcare service utilization, effective coverage, and health care spending. AIM 4: Quantify the relationship between multimorbidity and frailty, and associated excess mortality risks, and develop integrative measures of healthy life expectancy.

项目 5：多重疾病——摘要 人们对了解多种疾病的模式、决定因素和后果非常感兴趣 但在高收入环境之外进行的研究相对较少。 撒哈拉以南非洲人口正在迅速老龄化，导致多种慢性病的负担不断增加， 由于艾滋病毒感染率高，特别是在艾滋病病毒感染率不断上升的时代，情况变得更加复杂。 通过抗逆转录病毒治疗生存。随着人口老龄化，影响认知功能的状况， 值得注意的是，阿尔茨海默病和相关的痴呆症进一步导致了复杂的多发病情况。 多重发病可能对身体和认知功能、心理健康、死亡率产生重大影响 脆弱性的概念已被提出作为描述健康状况的一种方式。 一致的衰老表型，结合了高度预测的健康和功能状态指标 健康状况下降和死亡率，以及多种疾病和虚弱之间的联系对于理解很重要 组织卫生系统并规划老龄人口的正式和非正式护理。 使用多发病作为综合镜头，通过它统一许多主要的经验观察 研究队列，并扩大与健康结果的社会和经济驱动因素相关的重要主题 人口老龄化将该计划中的所有项目联系起来，我们的总体目标是阐明人口老龄化的作用。 为了实现这一目标，多重发病率是一个由决定因素、结果和后果组成的复杂网络的联系。 该项目有四个具体目标： 目标 1：对南方老年人群体中多种疾病的流行病学进行全面描述 非洲人，包括其患病率和程度、发生率和轨迹、以及其模式和 决定因素。 目标 2：评估多种疾病对死亡率、身体和心理功能以及健康的影响 存在。 目标 3：评估多种疾病对医疗保健服务利用、有效覆盖范围和影响 医疗保健支出。 目标 4：量化多发病和虚弱之间的关系，以及相关的超额死亡风险， 制定健康预期寿命的综合措施。