Dataset Information

Multimorbidity, functional limitations, and outcomes: Interactions in a population-based cohort of older adults.

ABSTRACT:

Objective

To understand the interaction of multimorbidity and functional limitations in determining health-care utilization and survival in older adults.

Methods

Olmsted County, Minnesota, residents aged 60-89 years in 2005 were categorized into four cohorts based on the presence or absence of multimorbidity (?3 chronic conditions from a list of 18) and functional limitations (?1 limitation in an activity of daily living from a list of 9), and were followed through December 31, 2016. Andersen-Gill and Cox regression estimated hazard ratios (HRs) for emergency department (ED) visits, hospitalizations, and death using persons with neither multimorbidity nor functional limitations as the reference (interaction analyses).

Results

Among 13,145 persons, 34% had neither multimorbidity nor functional limitations, 44% had multimorbidity only, 4% had functional limitations only, and 18% had both. Over a median follow-up of 11 years, 5906 ED visits, 2654 hospitalizations, and 4559 deaths occurred. Synergistic interactions on an additive scale of multimorbidity and functional limitations were observed for all outcomes; however, the magnitude of the interactions decreased with advancing age. The HR (95% confidence interval) for death among persons with both multimorbidity and functional limitations was 5.34 (4.40-6.47) at age 60-69, 4.16 (3.59-4.83) at age 70-79, and 2.86 (2.45-3.35) at age 80-89 years.

Conclusion

The risk of ED visits, hospitalizations, and death among persons with both multimorbidity and functional limitations is greater than additive. The magnitude of the interaction was strongest for the youngest age group, highlighting the importance of interventions to prevent and effectively manage multimorbidity and functional limitations early in life.

SUBMITTER: Chamberlain AM

PROVIDER: S-EPMC6734596 | biostudies-literature | 2019 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Multimorbidity, functional limitations, and outcomes: Interactions in a population-based cohort of older adults.

Chamberlain Alanna M AM Rutten Lila J Finney LJF Jacobson Debra J DJ Fan Chun C Wilson Patrick M PM Rocca Walter A WA Roger Véronique L VL St Sauver Jennifer L JL

Journal of comorbidity 20190101

<h4>Objective</h4>To understand the interaction of multimorbidity and functional limitations in determining health-care utilization and survival in older adults.<h4>Methods</h4>Olmsted County, Minnesota, residents aged 60-89 years in 2005 were categorized into four cohorts based on the presence or absence of multimorbidity (≥3 chronic conditions from a list of 18) and functional limitations (≥1 limitation in an activity of daily living from a list of 9), and were followed through December 31, 20 ...[more]

PMID: 31523633

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Dataset Information

Multimorbidity, functional limitations, and outcomes: Interactions in a population-based cohort of older adults.

Objective

Methods

Results

Conclusion

Publications

Multimorbidity, functional limitations, and outcomes: Interactions in a population-based cohort of older adults.

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