Lauren E Griffith1, Parminder Raina1, Mélanie Levasseur2, Nazmul Sohel1, Hélène Payette3, Holly Tuokko4, Edwin van den Heuvel5, Andrew Wister6, Anne Gilsing1, Christopher Patterson7. 1. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. 2. School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada. 3. Research Center on Aging, CIUSSS de l'Estrie-CHUS, and Faculty of Medicine and Health Sciences Université de Sherbrooke, Sherbrooke, Quebec, Canada. 4. Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada. 5. Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands. 6. Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada. 7. Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Abstract
BACKGROUND: We examine the population impact on functional disability and social participation of physical and mental chronic conditions individually and in combination. METHODS: Cross-sectional, population-based data from community-dwelling people aged 45 years and over living in the 10 Canadian provinces in 2008-2009 were used to estimate the population attributable risk (PAR) for functional disability in basic (ADL) and instrumental (IADL) activities of daily living and social participation restrictions for individual and combinations of chronic conditions, stratified by age and gender, after adjusting for confounding variables. RESULTS: Five chronic conditions (arthritis, depression, diabetes, heart disease and eye disease) made the largest contributions to ADL-related and IADL-related functional disability and social participation restrictions, with variation in magnitude and ranking by age and gender. While arthritis was consistently associated with higher PARs across gender and most age groups, depression, alone and in combination with the physical chronic conditions, was associated with ADL and IADL disability as well as social participation restrictions in the younger age groups, especially among women. Compared to women, the combinations of conditions associated with higher PARs in men more often included heart disease and diabetes. CONCLUSIONS: Our findings suggest that in community-dwelling middle-aged and older adults, the impact of combinations of mental and physical chronic conditions on functional disability and social participation restriction is substantial and differed by gender and age. Recognising the differences in the drivers of PAR by gender and age group will ultimately increase the efficiency of clinical and public health interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: We examine the population impact on functional disability and social participation of physical and mental chronic conditions individually and in combination. METHODS: Cross-sectional, population-based data from community-dwelling people aged 45 years and over living in the 10 Canadian provinces in 2008-2009 were used to estimate the population attributable risk (PAR) for functional disability in basic (ADL) and instrumental (IADL) activities of daily living and social participation restrictions for individual and combinations of chronic conditions, stratified by age and gender, after adjusting for confounding variables. RESULTS: Five chronic conditions (arthritis, depression, diabetes, heart disease and eye disease) made the largest contributions to ADL-related and IADL-related functional disability and social participation restrictions, with variation in magnitude and ranking by age and gender. While arthritis was consistently associated with higher PARs across gender and most age groups, depression, alone and in combination with the physical chronic conditions, was associated with ADL and IADL disability as well as social participation restrictions in the younger age groups, especially among women. Compared to women, the combinations of conditions associated with higher PARs in men more often included heart disease and diabetes. CONCLUSIONS: Our findings suggest that in community-dwelling middle-aged and older adults, the impact of combinations of mental and physical chronic conditions on functional disability and social participation restriction is substantial and differed by gender and age. Recognising the differences in the drivers of PAR by gender and age group will ultimately increase the efficiency of clinical and public health interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Entities:
Keywords:
AGEING; CHRONIC DI; Functioning and disability; PUBLIC HEALTH; Social activities
Authors: Karen L Fingerman; Yee To Ng; Meng Huo; Kira S Birditt; Susan T Charles; Steven Zarit Journal: J Gerontol B Psychol Sci Soc Sci Date: 2021-11-15 Impact factor: 4.077
Authors: Amanda Wilkinson; Lucy Bowen; Elias Gustavsson; Simon Håkansson; Nicole Littleton; James McCormick; Michelle Thompson; Hilda Mulligan Journal: Int J Environ Res Public Health Date: 2019-05-28 Impact factor: 3.390
Authors: Anni Hämäläinen; Natalie Phillips; Walter Wittich; M Kathleen Pichora-Fuller; Paul Mick Journal: Sci Rep Date: 2019-12-23 Impact factor: 4.379
Authors: Parminder Raina; Anne Gilsing; Alexandra J Mayhew; Nazmul Sohel; Edwin van den Heuvel; Lauren E Griffith Journal: PLoS One Date: 2020-02-20 Impact factor: 3.240
Authors: Louise Norman Jespersen; Susan Ishøy Michelsen; Bjørn Evald Holstein; Tine Tjørnhøj-Thomsen; Pernille Due Journal: Health Qual Life Outcomes Date: 2018-10-11 Impact factor: 3.186