Stefano Marventano1, Alba Ayala2, Nerea Gonzalez3, Carmen Rodríguez-Blázquez4, Susana Garcia-Gutierrez3, Maria João Forjaz5. 1. Department "G.F. Ingrassia" Section of Hygiene and Public Health University of Catania, Italy. Electronic address: stefano.marventano@studium.unict.it. 2. National School of Public Health, Carlos III Institute of Health, Madrid, Spain. 3. Research Unit of Galdakao-Usansolo Hospital, Bilbao, Spain; Research Network on Health Services and Chronicity (REDISSEC), Spain. 4. National Centre of Epidemiology and Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain. 5. National School of Public Health, Carlos III Institute of Health, Madrid, Spain; Research Network on Health Services and Chronicity (REDISSEC), Spain.
Abstract
BACKGROUND: Multimorbidity is common in older people and may contribute to many adverse health events, such as disability. The aim of the study was to investigate how chronic health conditions (single, paired, and grouped) affect functional independence. METHOD: We used two samples (a one-time, convenience sample and a nationally representative cross-sectional survey) of community-dwelling people of 65 years old or over, with a total of 2818 subjects in Spain. To assess functional independence, we used the Barthel index, administered as an interview. Information about the presence of 11 chronic health problems was collected by interview or review of their medical chart. Explanatory factor analysis was performed to assess associations between chronic health conditions. RESULTS: Diabetes mellitus and hypertension emerged as the pair of chronic health conditions that most affected functional status [OR 1.98; 95% CI (1.51-2.60)], followed by visual and hearing impairment. A synergistic effect was found (p<0.05) for the cardiovascular disease and hypertension pair. Four multimorbidity groups emerged from the factor analysis: sensory and bone; cancer, lung and gastrointestinal; cardiovascular and metabolic; neuropsychiatric disorders. The neuropsychiatric disorders group was the most strongly associated with physical impairment [OR 4.94; 95% CI (2.71-8.99)], followed by the sensory and bones group [OR 1.90; 95% CI (1.56-2.31)]. CONCLUSION: Despite its low prevalence, the neuropsychiatric disorders group was most strongly associated with lower functional status. Analysis of the relationship between chronic medical conditions and functional status could be useful to develop primary health care strategies to improve functional independence in older people with comorbidities.
BACKGROUND: Multimorbidity is common in older people and may contribute to many adverse health events, such as disability. The aim of the study was to investigate how chronic health conditions (single, paired, and grouped) affect functional independence. METHOD: We used two samples (a one-time, convenience sample and a nationally representative cross-sectional survey) of community-dwelling people of 65 years old or over, with a total of 2818 subjects in Spain. To assess functional independence, we used the Barthel index, administered as an interview. Information about the presence of 11 chronic health problems was collected by interview or review of their medical chart. Explanatory factor analysis was performed to assess associations between chronic health conditions. RESULTS:Diabetes mellitus and hypertension emerged as the pair of chronic health conditions that most affected functional status [OR 1.98; 95% CI (1.51-2.60)], followed by visual and hearing impairment. A synergistic effect was found (p<0.05) for the cardiovascular disease and hypertension pair. Four multimorbidity groups emerged from the factor analysis: sensory and bone; cancer, lung and gastrointestinal; cardiovascular and metabolic; neuropsychiatric disorders. The neuropsychiatric disorders group was the most strongly associated with physical impairment [OR 4.94; 95% CI (2.71-8.99)], followed by the sensory and bones group [OR 1.90; 95% CI (1.56-2.31)]. CONCLUSION: Despite its low prevalence, the neuropsychiatric disorders group was most strongly associated with lower functional status. Analysis of the relationship between chronic medical conditions and functional status could be useful to develop primary health care strategies to improve functional independence in older people with comorbidities.
Authors: Eileen Rillamas-Sun; Andrea Z LaCroix; Christina L Bell; Kelli Ryckman; Judith K Ockene; Robert B Wallace Journal: J Gerontol A Biol Sci Med Sci Date: 2016-03 Impact factor: 6.053
Authors: Monica Tang; Andrea L Schaffer; Belinda E Kiely; Benjamin Daniels; Chee K Lee; Robert J Simes; Sallie-Anne Pearson Journal: Breast Cancer Res Treat Date: 2021-02-22 Impact factor: 4.872
Authors: A Calderón-Larrañaga; D L Vetrano; L Ferrucci; S W Mercer; A Marengoni; G Onder; M Eriksdotter; L Fratiglioni Journal: J Intern Med Date: 2018-11-22 Impact factor: 8.989
Authors: Elisa Fabbri; Marco Zoli; Marta Gonzalez-Freire; Marcel E Salive; Stephanie A Studenski; Luigi Ferrucci Journal: J Am Med Dir Assoc Date: 2015-05-07 Impact factor: 4.669