Patterns of multimorbidity and risk of disability in community-dwelling older persons

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The aim was to analyze the association between specific patterns of multimorbidity and risk of disability in older persons. Data were gathered from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K); 2066 60 + year-old participants living in the community and free from disability at baseline were grouped according to their multimorbidity patterns and followed-up for six years. The association between multimorbidity patterns and disability in basic (ADL) and instrumental (IADL) activities of daily living was examined through multinomial models. Throughout the follow-up, 434 (21.0%) participants developed at least one ADL and 310 (15.0%) at least one IADL. Compared to the unspecific pattern, which included diseases not exceeding their expected prevalence in the total sample, belonging to the cardiovascular/anemia/dementia, the sensory impairment/cancer and the musculoskeletal/respiratory/gastrointestinal patterns was associated with a higher risk of developing both ADL and IADL, whereas subjects in the metabolic/sleep disorders pattern showed a higher risk of developing only IADL. Multimorbidity patterns are differentially associated with incident disability, which is important for the design of future prevention strategies aimed at delaying functional impairment in old age, and for a better healthcare resource planning.

Supplementary information

The online version contains supplementary material available at (10.1007/s40520-020-01773-z).

Related collections

Most cited references 18

Record: found
Abstract: found
Article: found

Is Open Access

Measuring biological aging in humans: A quest

Luigi Ferrucci, Marta Gonzalez-Freire, Elisa Fabbri … (2019)

Abstract The global population of individuals over the age of 65 is growing at an unprecedented rate and is expected to reach 1.6 billion by 2050. Most older individuals are affected by multiple chronic diseases, leading to complex drug treatments and increased risk of physical and cognitive disability. Improving or preserving the health and quality of life of these individuals is challenging due to a lack of well‐established clinical guidelines. Physicians are often forced to engage in cycles of “trial and error” that are centered on palliative treatment of symptoms rather than the root cause, often resulting in dubious outcomes. Recently, geroscience challenged this view, proposing that the underlying biological mechanisms of aging are central to the global increase in susceptibility to disease and disability that occurs with aging. In fact, strong correlations have recently been revealed between health dimensions and phenotypes that are typical of aging, especially with autophagy, mitochondrial function, cellular senescence, and DNA methylation. Current research focuses on measuring the pace of aging to identify individuals who are “aging faster” to test and develop interventions that could prevent or delay the progression of multimorbidity and disability with aging. Understanding how the underlying biological mechanisms of aging connect to and impact longitudinal changes in health trajectories offers a unique opportunity to identify resilience mechanisms, their dynamic changes, and their impact on stress responses. Harnessing how to evoke and control resilience mechanisms in individuals with successful aging could lead to writing a new chapter in human medicine.

0 comments Cited 221 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC).

Mårten Lagergren, Laura Fratiglioni, Ingalill Rahm Hallberg … (2004)

A large, national, long-term, longitudinal, multi-purpose study has been launched in Sweden--the Swedish National study on Aging and Care (SNAC). The study involves four research centers collecting data in four different areas of Sweden. The study consists of two parts: the population part and the care and services part. In the population part, a large, representative panel of elders in different age cohorts is followed over time to record and describe the aging process from different aspects. In the care and services part, a systematic, longitudinal, individually-based collection of data is performed concerning provision of care and services together with functional ability, specific health care problems, and living conditions of the recipients living in the area. The data collection in the population part of the SNAC is not yet completed. In the present article, some preliminary results are reported from the care and services part. These pertain to comparisons between the participating areas with respect to the prevalence of disability among those receiving care and social services in their ordinary homes and those receiving care in special accommodation. A comparison is also presented with regard to the amount of home help provided to subjects with a given disability. This project has several advantages. It is expected to generate a rich data base relevant for future research on aging and care and to have a direct impact on the future Swedish system of care and services for the elderly.

0 comments Cited 171 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Assessing and Measuring Chronic Multimorbidity in the Older Population: A Proposal for Its Operationalization

Amaia Calderón-Larrañaga, Davide L. Vetrano, Graziano Onder … (2016)

Abstract Background Although the definition of multimorbidity as “the simultaneous presence of two or more chronic diseases” is well established, its operationalization is not yet agreed. This study aims to provide a clinically driven comprehensive list of chronic conditions to be included when measuring multimorbidity. Methods Based on a consensus definition of chronic disease, all four-digit level codes from the International Classification of Diseases, 10th revision (ICD-10) were classified as chronic or not by an international and multidisciplinary team. Chronic ICD-10 codes were subsequently grouped into broader categories according to clinical criteria. Last, we showed proof of concept by applying the classification to older adults from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K) using also inpatient data from the Swedish National Patient Register. Results A disease or condition was considered to be chronic if it had a prolonged duration and either (a) left residual disability or worsening quality of life or (b) required a long period of care, treatment, or rehabilitation. After applying this definition in relation to populations of older adults, 918 chronic ICD-10 codes were identified and grouped into 60 chronic disease categories. In SNAC-K, 88.6% had ≥2 of these 60 disease categories, 73.2% had ≥3, and 55.8% had ≥4. Conclusions This operational measure of multimorbidity, which can be implemented using either or both clinical and administrative data, may facilitate its monitoring and international comparison. Once validated, it may enable the advancement and evolution of conceptual and theoretical aspects of multimorbidity that will eventually lead to better care.

0 comments Cited 125 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Alessandra Marengoni:

ORCID: http://orcid.org/0000-0002-4851-1825

Alessandra.marengoni@unibs.it

Journal

Journal ID (nlm-ta): Aging Clin Exp Res

Journal ID (iso-abbrev): Aging Clin Exp Res

Title: Aging Clinical and Experimental Research

Publisher: Springer International Publishing (Cham )

ISSN (Print): 1594-0667

ISSN (Electronic): 1720-8319

Publication date (Electronic): 13 February 2021

Publication date PMC-release: 13 February 2021

Publication date (Print): 2021

Volume: 33

Issue: 2

Pages: 457-462

Affiliations

[1 ]GRID grid.7637.5, ISNI 0000000417571846, Department of Clinical and Experimental Sciences, , University of Brescia, ; Brescia, Italy

[2 ]GRID grid.10548.38, ISNI 0000 0004 1936 9377, Aging Research Center, Department of Neurobiology, Care Sciences and Society, , Karolinska Institutet and Stockholm University, ; Stockholm, Sweden

[3 ]GRID grid.8142.f, ISNI 0000 0001 0941 3192, Centro Medicina Dell’Invecchiamento, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, , Università Cattolica del Sacro Cuore, ; Rome, Italy

[4 ]Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via Corts Catalanes 587, Barcelona, Spain

[5 ]GRID grid.7080.f, Universitat Autònoma de Barcelona, ; Campus de la UAB, Bellaterra (Cerdanyola del Vallès), Spain

[6 ]GRID grid.416651.1, ISNI 0000 0000 9120 6856, Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, , Istituto Superiore Di Sanità, ; Rome, Italy

[7 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, , Karolinska Institutet, ; Stockholm, Sweden

[8 ]GRID grid.24381.3c, ISNI 0000 0000 9241 5705, Karolinska University Hospital, ; Stockholm, Sweden

[9 ]GRID grid.419683.1, ISNI 0000 0004 0513 0226, Stockholm Gerontology Research Center, ; Stockholm, Sweden

Author information

Alessandra Marengoni http://orcid.org/0000-0002-4851-1825

Article

Publisher ID: 1773

DOI: 10.1007/s40520-020-01773-z

PMC ID: 7914228

PubMed ID: 33580869

SO-VID: d95dacf0-077f-4c73-84e0-d307b18f8c5c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 25 October 2020

Date accepted : 3 December 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004359, Vetenskapsrådet;

Funded by: Karolinska Institute

Open Access :

Open Access funding provided by Karolinska Institute

Custom metadata

Keywords: multimorbidity patterns,disability,older persons

Data availability:

Keywords: multimorbidity patterns, disability, older persons

Comments

Comment on this article

scite_

Cited by 22

See all cited by

- Version 1

Patterns of multimorbidity and risk of disability in community-dwelling older persons

Read this article at

Abstract

Supplementary information

Related collections

Journal of Disability Research

Most cited references 18

Measuring biological aging in humans: A quest

A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC).

Assessing and Measuring Chronic Multimorbidity in the Older Population: A Proposal for Its Operationalization

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 430

Cited by 22