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Coexisting chronic conditions in the older population: Variation by health indicators
Alessandra Marengoni1, Sara Angleman2, Bettina Meinow2
1Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Italy.
Insights
The prevalence of coexisting chronic conditions in older adults varies significantly based on the health indicator used. Factors like age, sex, and education further influence these complex health patterns.
Area of Science:
- Gerontology
- Public Health
- Epidemiology
Background:
- Analyzing the prevalence and patterns of coexisting chronic conditions in older adults is crucial for understanding population health.
- Older adults often present with multiple health issues, necessitating comprehensive assessment.
Purpose of the Study:
- To investigate the prevalence and patterns of coexisting chronic conditions among older adults in Stockholm.
- To examine how different health indicators capture the complexity of chronic conditions in this demographic.
Main Methods:
- A cross-sectional study involving 3363 individuals aged 60 years and older in Stockholm.
- Chronic conditions were assessed using multimorbidity (≥2 diseases), Cumulative Illness Rating Scale, polypharmacy (≥5 drugs), and complex health problems.
Main Results:
- Prevalence of chronic conditions varied by indicator; multimorbidity affected 38% of 60-74 year olds and 76% of those ≥85.
- Polypharmacy was also common, observed in 24.3% of 60-74 year olds and 59% of those ≥85.
- Older age, female sex, and lower educational level were associated with higher prevalence of certain health indicators.
Conclusions:
- The choice of health indicator significantly impacts the estimated prevalence of coexisting chronic conditions in older adults.
- Age, sex, and education level are important factors that modify the presentation of complex health issues.
- Utilizing diverse indicators is essential for accurately assessing and addressing the multifaceted health needs of the elderly population.
Background:
This study analyzes the prevalence and patterns of coexisting chronic conditions in older adults.
Design:
Cross-sectional.
Participant And Setting:
A sample of 3363 people ≥60years living in Stockholm were examined from March 2001 through August 2004.
Measurements:
Chronic conditions were measured with: 1) multimorbidity (≥2 concurrent chronic diseases); 2) the Cumulative Illness Rating Scale, 3) polypharmacy (≥5 prescribed drugs), and 4) complex health problems (chronic diseases and/or symptoms along with cognitive and/or functional limitations).
Results:
A total of 55.6% of 60-74year olds and 13.4% of those ≥85years did not have chronic conditions according to the four indicators. Multimorbidity and polypharmacy were the most prevalent indicators: 38% aged 60-74 and 76% aged ≥85 had multimorbidity; 24.3% aged 60-74 and 59% aged ≥85 had polypharmacy. Prevalence of chronic conditions as indicated by the comorbidity index and complex health problems ranged from 16.5% and 1.5% in the 60-74year olds to 38% and 36% in the 85+ year olds, respectively. Prevalence of participants with 4 indicators was low, varying from 1.6% in those aged 60-74 to 14.9% in those aged ≥85years. Older age was associated with higher odds of each of the 4 indicators; being a woman, with all indicators but multimorbidity; and lower educational level, only with complex health problems.
Conclusions:
Prevalence of coexisting chronic conditions varies greatly by health indicator used. Variation increases when age, sex, and educational level are taken into account. These findings underscore the need of different indicators to capture health complexity in older adults.
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