Henrike Galenkamp1, Arjan W Braam, Martijn Huisman, Dorly J H Deeg. 1. Department of Epidemiology and Biostatistics, EMGO/Longitudinal Aging Study Amsterdam, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. h.galenkamp@vumc.nl
Abstract
OBJECTIVES: Chronic diseases are important predictors of self-rated health (SRH). This study investigated whether multimorbidity has a synergistic or cumulative impact on SRH. Moderation by gender and age was examined. METHODS: Data originated from the Longitudinal Aging Study Amsterdam (N=2046, aged 57-98 years). We assessed the presence of lung disease, cardiac disease, peripheral atherosclerosis, stroke, diabetes mellitus, arthritis, and cancer. SRH was measured with the question "How is your health in general?" including 5 response categories. Generalized ordered probit models were applied; possible synergism was examined by testing for nonlinearity of the association. RESULTS: The association between multimorbidity and SRH was nonlinear in that the effect of having a single disease was larger than the added effects of co-occurring diseases. However, from the second disease onward, each additional co-occurring disease caused cumulative declines in SRH. Only in the oldest old (85+), the impact of a single disease was similar to that of co-occurring diseases. Results were similar for men and women. DISCUSSION: Our findings help to improve understanding of the impact multimorbidity has on SRH: Having a single disease increases the chance of poor health more than each co-occurring disease, indicating some overlap between diseases or adaptation to declining health.
OBJECTIVES:Chronic diseases are important predictors of self-rated health (SRH). This study investigated whether multimorbidity has a synergistic or cumulative impact on SRH. Moderation by gender and age was examined. METHODS: Data originated from the Longitudinal Aging Study Amsterdam (N=2046, aged 57-98 years). We assessed the presence of lung disease, cardiac disease, peripheral atherosclerosis, stroke, diabetes mellitus, arthritis, and cancer. SRH was measured with the question "How is your health in general?" including 5 response categories. Generalized ordered probit models were applied; possible synergism was examined by testing for nonlinearity of the association. RESULTS: The association between multimorbidity and SRH was nonlinear in that the effect of having a single disease was larger than the added effects of co-occurring diseases. However, from the second disease onward, each additional co-occurring disease caused cumulative declines in SRH. Only in the oldest old (85+), the impact of a single disease was similar to that of co-occurring diseases. Results were similar for men and women. DISCUSSION: Our findings help to improve understanding of the impact multimorbidity has on SRH: Having a single disease increases the chance of poor health more than each co-occurring disease, indicating some overlap between diseases or adaptation to declining health.
Authors: Calypse B Agborsangaya; Darren Lau; Markus Lahtinen; Tim Cooke; Jeffrey A Johnson Journal: Qual Life Res Date: 2012-06-09 Impact factor: 4.147
Authors: Olga McDaid; Mark J Hanly; Kathryn Richardson; Frank Kee; Rose Anne Kenny; George M Savva Journal: BMJ Open Date: 2013-06-21 Impact factor: 2.692
Authors: Henrike Galenkamp; Dorly J H Deeg; Renate T de Jongh; Jan W P F Kardaun; Martijn Huisman Journal: BMJ Open Date: 2016-08-16 Impact factor: 2.692
Authors: N M van Schoor; S Zambon; M V Castell; C Cooper; M Denkinger; E M Dennison; M H Edwards; F Herbolsheimer; S Maggi; M Sánchez-Martinez; N L Pedersen; R Peter; L A Schaap; J J M Rijnhart; S van der Pas; D J H Deeg Journal: Qual Life Res Date: 2015-11-07 Impact factor: 4.147