美国老年人群的哮喘患病率:年龄仍然是一大影响因素
2012/11/09
摘要
目的:在过去30年中,哮喘死亡在65岁及以上人群中的负担最大。本试验在美国老年人群中研究年龄与哮喘患病之间的关系。
方法:对2001~2010国家健康访谈调查(NHIS)中54485名年龄为65岁及以上的美国公民的汇总数据进行分析。以5岁为一个年龄组和基于年龄阶段(“年轻老人”: 65~84岁,年长老人:≥85岁),估计美国老年人的当前哮喘、一生中患哮喘和慢性阻塞性肺疾病(COPD)的患病率。计算校正后的优势比(AOR)和95%可信区间(CI),分析老年人群中哮喘患病率形式。
结果:2001年至2010年,美国老年人群中每年的当前哮喘平均患病率为7.0%。一生中哮喘、COPD和同时患当前哮喘与COPD的发生率分别为9.9%、9.7%和3.0%。随着年龄增加,哮喘患病率成下降趋势,而COPD随年龄增加呈上升趋势。对研究变量和与COPD相互作用的因素控制后,与65-69岁人群相比,报道当前哮喘的优势比随着年龄增加呈下降趋势:70-74岁:0.87 (95% CI, 0.76-1.01);75-79岁:0.76 (95% CI, 0.66-0.87);80-84岁:0.62 (95% CI, 0.51-0.75);≥85岁:0.45 (95% CI, 0.36-0.55)。
结论:哮喘影响着相当一部分的美国老年人。COPD诊断增加可能会掩盖老年人群中哮喘的正确诊断和治疗。治疗指南应该关注可预防的风险行为,以增加老年人群的生活质量。
(苏楠 审校)
J Asthma. 2012 Aug;49(6):593-9. Epub 2012 Jul 6.
Asthma Prevalence among US Elderly by Age Groups: Age Still Matters.
Oraka E, Kim HJ, King ME, Callahan DB.
Source
Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention , Atlanta, GA , USA.
Abstract
OBJECTIVE:For over three decades, the greatest burden of asthma deaths has occurred among persons aged 65 years and older. This study analyzed the association between increasing age and asthma prevalence among age groups within the US elderly population.
METHODS:We analyzed aggregated data on 54,485 civilian, noninstitutionalized US adults aged 65 years and older from the 2001-2010 National Health Interview Survey (NHIS). We estimated the prevalence of current asthma, lifetime asthma, and chronic obstructive pulmonary disease (COPD) among US elderly by 5-year age groups and age stages ("young elderly" aged 65-84 years and "oldest old" aged ≥85 years). We calculated adjusted odds ratios (AOR) and 95% confidence intervals (CI) to identify asthma prevalence patterns among elderly populations.
RESULTS:From 2001 to 2010, the estimated average annual prevalence of current asthma among US elderly was 7.0%. Estimates of lifetime asthma, COPD, and co-occurring current asthma and COPD were 9.9%, 9.7%, and 3.0%, respectively. Prevalence of asthma decreased with advancing age while prevalence of COPD increased with advancing age. When controlling for study variables and significant interactions (p = .05) with COPD, the odds of reporting current asthma decreased with advancing age: 0.87 (95% CI, 0.76-1.01) for 70- to 74-year-olds; 0.76 (95% CI, 0.66-0.87) for 75- to 79-year-olds; 0.62 (95% CI, 0.51-0.75) for 80- to 84-year-olds; and 0.45 (95% CI, 0.36-0.55) for ≥85-year-olds, as compared to 65- to 69-year-olds.
CONCLUSIONS:Asthma continues to affect a substantial proportion of the US elderly population. Increased diagnosis of COPD may overshadow correct diagnosis and treatment in populations with advancing age. Treatment guidelines should focus on preventable risk behaviors to increase the quality of life within this population.
J Asthma. 2012 Aug;49(6):593-9. Epub 2012 Jul 6.
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