中老年人多重慢性疾病與自覺健康狀況關聯之探討

The Association Between Multiple Chronic Diseases and Self-Rated Health Among Middle-aged and Elderly People

目的：世界各地人口逐漸老化，全球60歲以上老年人口於2013年達11.70%，台灣60歲以上的人口分佈於2016年九月底已高達19.60%。隨著人口老化，慢性疾病增加並對民眾健康有所威脅，尤其是多重慢性疾病的罹患。本研究目的在於探討多重慢性疾病與自覺健康狀況之間的關聯。方法本研究使用「台灣第三次的國民營養健康狀況變遷調查」，針對45歲以上之民眾進行探討。納入人口學變項、抽菸行為、嚼檳榔行為、飲酒行為、運動情形、肥胖情形等變項、探討慢性疾病種類、組合與自覺健康狀況之間的關聯。結果在九項慢性疾病中，高血壓（34.81%）患病比率為其中最高，在兩項慢性疾病組合中以高血壓與心臟病者（7.49%）比率最高。複邏輯迴歸結果顯示慢性疾病種類及組合對民眾自覺健康狀況較差有顯著影響，其中罹患中風（OR＝2.60）自覺健康情形最差，而在兩項慢性疾病中以罹患中風與關節炎（OR＝13.36）自覺健康情形最不理想。結論慢性疾病種類顯著影響自覺健康狀況，在單項疾病中，以中風的影響最大，瞭解慢性疾病組合對民眾健康影響狀況，以提升慢性疾病的自我照顧，是增進中老年人健康生活品質的方式。

Purposes The global population is gradually aging. The population over 60 years old worldwide and in Taiwan is 11.70% and 19.60%, respectively. With population aging, the prevalence of chronic disease is increasing and has an impact on health, especially for those with multiple chronic diseases. The aim of this study is to examine the association between diagnosis with multiple chronic diseases and self-rated health after controlling for demographic and health-related factors. Methods The study data are derived from the 2004-2008 Nutrition and Health Survey in Taiwan, and only included those over age 45 years. Logistic regression was used to analyze the relation between diagnosis with multiple chronic diseases and self-rated health. Results The study revealed that hypertension (34.81%) and hypertension combined with heart disease (7.49%) are the most prevalent chronic diseases. Stoke and stroke with arthritis have higher odds ratios (OR=2.60 and OR=13.36, respectively) for worse self-rated health status after controlling for associated factors. Conclusions Diagnosis with multiple chronic diseases is significantly associated with self-rated health. Stroke and its comorbidities have the greatest influence on health status. The quality of life for the elderly can be improved by understanding the impact of different chronic diseases and their comorbidities.