What is the impact of one’s chronic illness on his or her spouse’s future chronic illness: a community-based prospective cohort study

BMC Medicine

Research Article

Dong Woo Lee¹  Joon Hyuk Park²  Hoyoung An³  Jong Bin Bae⁴  Jin Shin⁴  Ji Won Han⁴  Hee Won Yang⁴  Dong Gyu Moon⁴  Ki Woong Kim⁵  Shin Gyeom Kim⁶  Seok Bum Lee⁷  Jung Jae Lee⁷  Kyung Phil Kwak⁸  Eunji Lim⁹  Bong Jo Kim^1,10  Jin Hyeong Jhoo^1,11  Jeong Lan Kim^1,12  Seok Woo Moon^1,13  Seung-Ho Ryu^1,14  Seonjeong Byun^1,15  Tae Hui Kim^1,16  Seung Wan Suh^1,17  Dae Jong Oh^1,18 

[1] Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea;Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea;Department of Neuropsychiatry, Keyo Hospital, Uiwang-Si, South Korea;Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea;Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea;Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea;Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea;Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea;Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea;Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea;Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, South Korea;Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, South Korea;Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, South Korea;Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea;Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea;Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea;Department of Psychiatry, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea;Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea;Seoul Heal Mental Health Clinic, Seoul, South Korea;Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;

关键词: Chronic disease;    Disease management;    Spouse;    Aged;    Geriatrics;   

DOI  :  10.1186/s12916-023-03061-9

 received in 2023-03-12, accepted in 2023-09-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIntegrating a joint approach to chronic disease management within the context of a couple has immense potential as a valuable strategy for both prevention and treatment. Although spousal concordance has been reported in specific chronic illnesses, the impact they cumulatively exert on a spouse in a longitudinal setting has not been investigated. We aimed to determine whether one’s cumulative illness burden has a longitudinal impact on that of their spouse.MethodsData was acquired from a community-based prospective cohort that included Koreans aged 60 years and over, randomly sampled from 13 districts nationwide. Data from the baseline assessment (conducted from November 2010 to October 2012) up to the 8-year follow-up assessment was analyzed from October 2021 to November 2022. At the last assessment, partners of the index participants were invited, and we included 814 couples in the analysis after excluding 51 with incomplete variables. Chronic illness burden of the participants was measured by the Cumulative Illness Rating Scale (CIRS). Multivariable linear regression and causal mediation analysis were used to examine the longitudinal effects of index chronic illness burden at baseline and its change during follow-up on future index and spouse CIRS scores.ResultsIndex participants were divided based on baseline CIRS scores (CIRS < 6 points, n = 555, mean [SD] age 66.3 [4.79] years, 43% women; CIRS ≥ 6 points, n = 259, mean [SD] age 67.7 [4.76] years, 36% women). The baseline index CIRS scores and change in index CIRS scores during follow-up were associated with the spouse CIRS scores (β = 0.154 [SE: 0.039], p < 0.001 for baseline index CIRS; β = 0.126 [SE: 0.041], p = 0.002 for change in index CIRS) at the 8-year follow-up assessment. Subgroup analysis found similar results only in the high CIRS group. The baseline index CIRS scores and change in index CIRS scores during follow-up had both direct and indirect effects on the spouse CIRS scores at the 8-year follow-up assessment.ConclusionsThe severity and course of one’s chronic illnesses had a significant effect on their spouse’s future chronic illness particularly when it was severe. Management strategies for chronic diseases that are centered on couples may be more effective.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 4