Alanna M Chamberlain1,2,3, Jennifer L St Sauver1,2, Cynthia M Boyd4, Lila J Finney Rutten1,2, Chun Fan1, Debra J Jacobson1,2, Walter A Rocca1,5,6. 1. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA. 2. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. 3. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. 4. Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, USA. 5. Department of Neurology, Mayo Clinic, Rochester, MN, USA. 6. Women's Health Research Center, Mayo Clinic, Rochester, MN, USA.
Abstract
Background: Persons who accumulate chronic conditions at a rate faster than their peers may experience accelerated aging and poor health outcomes, including functional limitations. Methods: Adults aged ≥40 years who resided in Olmsted County, Minnesota on 1 January 2006 were identified. The prevalence of 21 chronic conditions was ascertained, and age-specific quartiles of the number of chronic conditions was estimated within 4 age groups: 40-54, 55-64, 65-74, and ≥75 years. Difficulty with nine patient-reported functional limitations (including basic and instrumental activities of daily living and mobility activities) were ascertained through 31 October 2018. Cox regression was used to model associations of chronic condition quartiles with new-onset functional limitations considered separately. We estimated absolute risk differences and hazard ratios stratified by age group, and adjusted for sex, race, ethnicity, marital status, education, and the residual effect of age. Results: Among 39,624 persons (44.5% men, 93.2% white), the most common reported new functional limitations were difficulty with climbing stairs, walking, and housekeeping. For all functional limitations, the absolute risk differences were largest among the oldest age group (≥75 years). Approximately twofold increased hazard ratios were observed among those in the highest vs. lowest quartile for the three oldest age groups, and approximately threefold or higher hazard ratios were observed for persons aged 40-54 years. Conclusion: Persons with increased accumulation of chronic conditions experience increased risks of developing functional limitations compared to their peers. These findings underscore the importance of assessing health status and of employing interventions to prevent and effectively manage multi-morbidity at all ages.
Background: Persons who accumulate chronic conditions at a rate faster than their peers may experience accelerated aging and poor health outcomes, including functional limitations. Methods: Adults aged ≥40 years who resided in Olmsted County, Minnesota on 1 January 2006 were identified. The prevalence of 21 chronic conditions was ascertained, and age-specific quartiles of the number of chronic conditions was estimated within 4 age groups: 40-54, 55-64, 65-74, and ≥75 years. Difficulty with nine patient-reported functional limitations (including basic and instrumental activities of daily living and mobility activities) were ascertained through 31 October 2018. Cox regression was used to model associations of chronic condition quartiles with new-onset functional limitations considered separately. We estimated absolute risk differences and hazard ratios stratified by age group, and adjusted for sex, race, ethnicity, marital status, education, and the residual effect of age. Results: Among 39,624 persons (44.5% men, 93.2% white), the most common reported new functional limitations were difficulty with climbing stairs, walking, and housekeeping. For all functional limitations, the absolute risk differences were largest among the oldest age group (≥75 years). Approximately twofold increased hazard ratios were observed among those in the highest vs. lowest quartile for the three oldest age groups, and approximately threefold or higher hazard ratios were observed for persons aged 40-54 years. Conclusion: Persons with increased accumulation of chronic conditions experience increased risks of developing functional limitations compared to their peers. These findings underscore the importance of assessing health status and of employing interventions to prevent and effectively manage multi-morbidity at all ages.
Authors: Jennifer L St Sauver; Brandon R Grossardt; Barbara P Yawn; L Joseph Melton; Joshua J Pankratz; Scott M Brue; Walter A Rocca Journal: Int J Epidemiol Date: 2012-11-18 Impact factor: 7.196
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Authors: A Calderón-Larrañaga; G Santoni; H X Wang; A K Welmer; D Rizzuto; D L Vetrano; A Marengoni; L Fratiglioni Journal: J Intern Med Date: 2018-03-12 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
Authors: Walter A Rocca; Barbara P Yawn; Jennifer L St Sauver; Brandon R Grossardt; L Joseph Melton Journal: Mayo Clin Proc Date: 2012-11-28 Impact factor: 7.616
Authors: Walter A Rocca; Brandon R Grossardt; Cynthia M Boyd; Alanna M Chamberlain; William V Bobo; Jennifer L St Sauver Journal: BMJ Open Date: 2021-03-19 Impact factor: 3.006