Dataset Information

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.

ABSTRACT:

Background

Multimorbidity is defined as the presence of multiple chronic conditions in the same individual. Multimorbidity is more prevalent in older adults and can lead to several adverse health outcomes.

Methods

We systematically reviewed evidence from observational studies to verify the association between multimorbidity and hospitalization in older adults. Furthermore, we also aimed to identify whether it changes according to gender, advanced age, institutionalization, and wealth of the country of residence. We searched the PubMed, Embase and Scopus databases from December 2020 to April 2021. The analysed outcomes were as follows: hospitalization, length of stay and hospital readmission.

Results

Of the 6,948 studies identified in the databases, 33 were included in this review. From the meta-analysis results, it was found that multimorbidity, regardless of the country's wealth, was linked to hospitalization in older adults (OR = 2.52, CI 95% = 1.87-3.38). Both definitions of multimorbidity, ≥2 (OR = 2.35, 95% CI = 1.34-4.12) and ≥3 morbidities (OR = 2.52, 95% CI = 1.87-3.38), were associated with hospitalization. Regardless of gender, multimorbidity was associated with hospitalization (OR = 1.98, 95% CI = 1.67-2.34) and with readmission (OR = 1.07, 95% CI = 1.04-1.09). However, it was not possible to verify the association between multimorbidity and length of stay.

Conclusions

Multimorbidity was linked to a higher hospitalization risk, and this risk was not affected by the country's wealth and patient's gender. Multimorbidity was also linked to a higher hospital readmission rate in older adults. PROSPERO Registration (Registration number: CRD42021229328).

SUBMITTER: Rodrigues LP

PROVIDER: S-EPMC9308991 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.

Rodrigues Luciana Pereira LP de Oliveira Rezende Andréa Toledo AT Delpino Felipe Mendes FM Mendonça Carolina Rodrigues CR Noll Matias M Nunes Bruno Pereira BP de Oliviera Cesar C Silveira Erika Aparecida EA

Age and ageing 20220701 7

<h4>Background</h4>Multimorbidity is defined as the presence of multiple chronic conditions in the same individual. Multimorbidity is more prevalent in older adults and can lead to several adverse health outcomes.<h4>Methods</h4>We systematically reviewed evidence from observational studies to verify the association between multimorbidity and hospitalization in older adults. Furthermore, we also aimed to identify whether it changes according to gender, advanced age, institutionalization, and wea ...[more]

PMID: 35871422

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Project description:BackgroundMultimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India.MethodsThe JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta-analysis, where appropriate.ResultsOut of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta-analysis, respectively. All included studies were cross-sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions-related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60-69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20-1.91), females compared to males (1.38; 1.09-1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11-1.49), economically dependent compared to economically independent (1.54; 1.21-1.97), and smokers compared to non-smokers (1.33; 1.16-1.52) and were lower in working compared to not working (0.51; 0.36-0.72).ConclusionThis systematic review and meta-analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.

Project description:BackgroundSedentary behaviour is considered to contribute to sarcopenia when combined with physical inactivity. Whether sedentary behaviour is independently associated with sarcopenia remains controversial. The aim of this study is to explore the association between sedentary behaviour and sarcopenia in older adults in community and long-term care facility settings.MethodsEight electronic databases including MEDLINE, PsycINFO, Wanfang were searched from inception until August 2023. The review included cross-sectional and longitudinal studies concerning the association between sedentary behaviour and sarcopenia among participants over 60 years old. Evidence was pooled by both random-effects meta-analysis and narrative synthesis. Subgroup analyses explored variation according to adjustment of physical activity, settings, and measurements of sedentary behaviour and sarcopenia. Quality assessment for individual studies was performed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist.ResultsSeventeen articles (16 cross-sectional studies and 1 longitudinal study) of 25,788 participants from community or long-term care facility settings were included. The overall quality of the included studies was rated high. Meta-analysis of 14 cross-sectional studies showed that sedentary behaviour was independently positively associated with sarcopenia: pooled odd ratio 1.36 (95% confidence interval, 1.18-1.58). The independent positive association remained in subgroup analyses by adjustment of physical activity, settings, and measurements of sedentary behaviour and sarcopenia. The narrative analysis corroborated the findings of the meta-analysis and provided additional evidence suggesting that interruptions in sedentary periods were linked to a decreased likelihood of developing sarcopenia.ConclusionsThe findings support the hypothesis that sedentary behaviour is independently positively associated with sarcopenia in older adults, providing vital indications for the development of strategies to prevent sarcopenia.Systematic review registrationThe systematic review protocol has been registered with the PROSPERO database (CRD42022311399).

Project description:Importance:Chronic noncancer pain (hereafter referred to as chronic pain) is common among older adults and managed frequently with pharmacotherapies that produce suboptimal outcomes. Psychological treatments are recommended, but little information is available regarding their efficacy in older adults. Objective:To determine the efficacy of psychological interventions in older adults with chronic pain and whether treatment effects vary by participant, intervention, and study characteristics. Data Sources:MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from inception to March 29, 2017. Study Selection:Analysis included studies that (1) used a randomized trial design, (2) evaluated a psychological intervention that used cognitive behavioral modalities alone or in combination with another strategy, (3) enrolled individuals with chronic pain (pain ≥3 months) with a sample mean age of 60 years or older, and (4) reported preintervention and postintervention quantitative data. Data Extraction and Synthesis:Two of the authors independently extracted data. A mixed-model meta-analysis tested the effects of treatment on outcomes. Analyses were performed to investigate the association between participant (eg, age), intervention (eg, treatment mode delivery), and study (eg, methodologic quality) characteristics with outcomes. Main Outcomes and Measures:Pain intensity was the primary outcome; secondary outcomes included pain interference, depressive symptoms, anxiety, catastrophizing beliefs, self-efficacy for managing pain, physical function, and physical health. Results:Twenty-two studies with 2608 participants (1799 [69.0%] women) were analyzed. Participants' mean (SD) age was 71.9 (7.1) years. Differences of standardized mean differences (dD) at posttreatment were pain intensity (dD = -0.181, P = .006), pain interference (dD = -0.133, P = .12), depressive symptoms (dD = -0.128, P = .14), anxiety (dD = -0.205, P = .09), catastrophizing beliefs (dD = -0.184, P = .046), self-efficacy (dD = 0.193, P = .02), physical function (dD = 0.006, P = .96), and physical health (dD = 0.160, P = .24). There was evidence of effects persisting beyond the posttreatment assessment only for pain (dD = -0.251, P = .002). In moderator analyses, only mode of therapy (group vs individual) demonstrated a consistent effect in favor of group-based therapy. Conclusions and Relevance:Psychological interventions for the treatment of chronic pain in older adults have small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain. These results were strongest when delivered using group-based approaches. Research is needed to develop and test strategies that enhance the efficacy of psychological approaches and sustainability of treatment effects among older adults with chronic pain.

Dataset Information

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.

Background

Methods

Results

Conclusions

Publications

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.

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