Clinical disorders in a post war British cohort reaching retirement: evidence from the First National Birth Cohort Study

Autor: Pierce, Mary B, Silverwood, Richard J, Nitsch, Dorothea, Adams, Judith E, Stephen, Alison M, Nip, Wing, Macfarlane, Peter, Wong, Andrew, Richards, Marcus, Hardy, Rebecca, Kuh, Diana, NSHD Scientific and Data Collection Teams
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
Gerontology
Non-Clinical Medicine
Pulmonology
World War II
Epidemiology
Health Status
Osteoporosis
Disease
030204 cardiovascular system & hematology
Cardiovascular
Cohort Studies
0302 clinical medicine
Cluster Analysis
Clinical Epidemiology
030212 general & internal medicine
Health Systems Strengthening
Retirement
Multidisciplinary
Middle Aged
3. Good health
Mental Health
Oncology
England
Nephrology
Cohort
Medicine
Female
Public Health
Research Article
Cohort study
Adult
Science
Disease cluster
03 medical and health sciences
Health Economics
Age Distribution
Diabetes mellitus
medicine
Humans
Sex Distribution
Primary Care
Elderly Care
Health Care Policy
business.industry
Parturition
Impaired fasting glucose
medicine.disease
Medical Practice Management
Obesity
Geriatrics
Metabolic Disorders
Self Report
business
Zdroj: PLoS ONE, Vol 7, Iss 9, p e44857 (2012)
PLoS ONE
ISSN: 1932-6203
Popis: Background\ud \ud The medical needs of older people are growing because the proportion of the older population is increasing and disease boundaries are widening. This study describes the distribution and clustering of 15 common clinical disorders requiring medical treatment or supervision in a representative British cohort approaching retirement, and how health tracked across adulthood.\ud Methods and Findings\ud \ud The data come from a cohort of 2661 men and women, 84% of the target sample, followed since birth in England, Scotland and Wales in 1946, and assessed at 60–64 years for: cardio and cerebro-vascular disease, hypertension, raised cholesterol, renal impairment, diabetes, obesity, hypothyroidism, hyperthyroidism, anaemia, respiratory disease, liver disease, psychiatric problems, cancers, atrial fibrillation on ECG and osteoporosis. We calculated the proportions disorder-free, with one or more disorders, and the level of undiagnosed disorders; and how these disorders cluster into latent classes and relate to health assessed at 36 years. Participants had, on average, two disorders (range 0–9); only 15% were disorder-free. The commonest disorders were hypertension (54.3%, 95% CI 51.8%–56.7%), obesity (31.1%, 28.8%–33.5%), raised cholesterol (25.6%, 23.1–28.26%), and diabetes or impaired fasting glucose (25.0%, 22.6–27.5%). A cluster of one in five individuals had a high probability of cardio-metabolic disorders and were twice as likely than others to have been in the poorest health at 36 years. The main limitations are that the native born sample is entirely white, and a combination of clinical assessments and self reports were used.\ud Conclusions\ud \ud Most British people reaching retirement already have clinical disorders requiring medical supervision. Widening disease definitions and the move from a disease-based to a risk-based medical model will increase pressure on health services. The promotion of healthy ageing should start earlier in life and consider the individual's ability to adapt to and self manage changes in health.
Databáze: OpenAIRE
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