Multimorbidity Patterns in Middle-Aged and Older Couples: Implications for Psychological Well-Being and Health Behaviors

中年和老年夫妇的多重发病模式：对心理健康和健康行为的影响

• 批准号: 9755288
• 负责人: Courtney A. Polenick
• 金额: $ 7.8万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9755288
• 关键词: Address; Adult; Adverse drug event; Affect; Age; Aging; Alcohol consumption; Area; Arthritis; Attenuated; Behavior; Belief; Buffers; Categories; Characteristics; Chronic; Chronic Disease; Clinical; Complex; Consequentialism; Couples; Data; Diabetes Mellitus; Education; Elderly; Family; Family member; Friends; Gender; Goals; Habits; Health; Health Promotion; Health and Retirement Study; Health behavior; Heart Diseases; Hospitalization; Individual; Intervention; Knowledge; Link; Literature; Long-Term Effects; Marriage; Mental Depression; Mental Health; Multiple Partners; Pattern; Personal Satisfaction; Persons; Physical activity; Psychosocial Factor; Public Health; Race; Research; Resources; Risk Behaviors; Role; Sampling; Self Care; Shapes; Sleep; Smoking; Source; Spouses; Time; Vulnerable Populations; Well in self; Work; aged; base; cardiovascular risk factor; caregiving; contextual factors; depressive symptoms; design; disability; ethnic minority population; family management; health care service utilization; health data; health disparity; holistic approach; hospitalization rates; human old age (65+); insight; member; middle age; mortality; multiple chronic conditions; neglect; older women; pain reduction; physical conditioning; psychosocial; racial and ethnic; routine care; sociodemographics; theories

PROJECT SUMMARY Multimorbidity is an increasingly prevalent public health concern among middle-aged and older adults. Multiple chronic conditions place a high burden on individuals and their families, leading to elevated rates of hospitalization, disability, and mortality. The spousal tie is a crucial source of health-related influence and support for aging adults with chronic illness. Yet little is known about how individuals with multimorbidity may affect and/or be affected by their spouse in ways that benefit or harm their long-term health. Moreover, few studies have considered multimorbidity in both spouses. Multiple chronic conditions may be particularly stressful when they involve management strategies that are discordant (e.g., reducing cardiovascular risk factors vs. reducing pain) within or between spouses due to heightened support needs. Discordant conditions may also strain limited personal resources and disrupt each partner's self-care routines, resulting in decreased health-promoting behaviors (e.g., physical activity) and increased health-risk behaviors (e.g., alcohol use) that ultimately diminish their health and well-being. This project will advance the literature by examining patterns of multimorbidity within mid- and late-life couples, their long-term implications for psychological well-being and health behaviors, and sociodemographic and psychosocial factors that may buffer or exacerbate these links. The proposed project will draw on data from ten waves (1996 to 2014) of the Health and Retirement Study (HRS), including both members of the spousal dyad. We will explore three specific areas of inquiry: First, we will determine patterns of multimorbidity within and between spouses, focusing on concordance in their management activities and whether patterns vary by sociodemographics. Second, we will evaluate long-term associations between couples' multimorbidity patterns and both spouses' psychological well-being (depressive symptoms) and health behaviors (sleep, physical activity, alcohol use, and smoking). Third, we will identify sociodemographic characteristics (age, gender, race, and education) and psychosocial resources (control beliefs, relationship quality with one's spouse, family members, and friends) that moderate these associations. This project will generate critical information about combinations of multiple chronic conditions that may have lasting effects on health and well-being in aging couples. Research has established that there are consistent associations between one spouse's illness and his or her partner's physical and psychological health; but prior work has placed a near exclusive emphasis on a single chronic condition in one spouse, neglecting an understanding of each partner's multiple conditions and their potential consequences for well- being and health within the marriage. Findings will inform targeted interventions to promote the long-term well- being of older individuals and families managing multiple chronic conditions as well as a more comprehensive approach to the treatment of multimorbidity.

项目摘要 在中年和老年人中，多种疾病是越来越普遍的公共卫生问题。 多种慢性病给个人及其家人带来很大的负担，导致率提高 住院，残疾和死亡率。配偶领带是与健康相关影响的关键来源， 支持慢性疾病的老年人。然而，关于多种多样的人如何可能知道 影响和/或受其配偶的影响，以受益或损害其长期健康的方式。而且，很少 研究都考虑了两位配偶的多种多发性。多种慢性病可能特别是 压力很大，涉及不一致的管理策略（例如，降低心血管风险 由于增强的支持需求，在配偶内或配偶之间或配偶之间的因素与减轻疼痛。不一致的条件 还可能限制有限的个人资源并破坏每个合作伙伴的自我保健例程，从而减少 促进健康的行为（例如体育锻炼）和增强的健康风险行为（例如，饮酒） 最终减少了他们的健康和福祉。该项目将通过研究模式来推动文献 中后期夫妇内的多种病态，它们对心理健康的长期影响和 健康行为以及社会人口统计学和心理社会因素可能会缓冲或加剧这些联系。 拟议的项目将借鉴健康和退休研究的十波（1996年至2014年）的数据 （HRS），包括配偶Dyad的两个成员。我们将探讨三个特定的询问领域：首先，我们 将确定配偶内部和配偶之间的多种多发性模式，重点是一致性 管理活动以及模式是否因社会人口统计学而异。其次，我们将评估长期 夫妻的多元车模式与配偶的心理健康之间的联系（抑郁症 症状）和健康行为（睡眠，体育锻炼，饮酒和吸烟）。第三，我们将确定 社会人口统计学特征（年龄，性别，种族和教育）和社会心理资源（控制 信仰，与配偶，家人和朋友的关系质量），以促进这些关联。 该项目将生成有关多种慢性疾病组合的关键信息 对衰老夫妇的健康和福祉产生持久影响。研究确定有 一个配偶的疾病与伴侣的身体和心理之间的一致联系 健康;但是，先前的工作几乎排他对一个配偶中的一个慢性病， 忽略对每个伴侣的多种条件的理解及其对良好的潜在后果 婚姻中的存在与健康。调查结果将告知有针对性的干预措施，以促进长期良好 是老年人和家庭管理多种慢性条件以及更全面的 治疗多种病的方法。