Multimorbidity patterns and associations with functional limitations among an aging population in prison

Area of Science:

• Geriatric Medicine
• Public Health
• Criminology

Background:

• Co-occurring chronic diseases are prevalent in aging populations and linked to functional limitations.
• Aging offenders exhibit higher rates of chronic, mental health, and substance use disorders compared to the general aging population.
• Understanding these patterns is crucial for addressing health disparities in correctional facilities.

Purpose of the Study:

• To identify patterns of co-occurring conditions among aging offenders (≥50 years old).
• To determine the association between these patterns and functional limitations.
• To examine the role of multimorbidity and age in functional impairments within this population.

Main Methods:

• Principal factor analysis (PFA) was used to identify patterns of co-occurring conditions in 2270 male offenders aged ≥50.
• Diagnoses for chronic diseases, mental health, substance use disorders, and functional limitations were extracted from electronic health records.
• Chi-square tests were employed to compare functional limitations between multimorbid and non-multimorbid groups.

Main Results:

• Three distinct patterns emerged: chronic diseases, geriatric conditions, and mental health/substance use disorders.
• Functional limitations were significantly associated with the chronic disease pattern (p=.03).
• Increasing age was the only significant factor associated with physical impairment when controlling for other variables (p=.02).

Conclusions:

• The chronic disease pattern in aging offenders mirrors findings in non-imprisoned populations.
• The lack of association between geriatric patterns and functional limitations was unexpected.
• Targeted interventions for chronic diseases may mitigate functional limitations in aging offenders.