Sex differences in functioning and disability among adults with cardiometabolic multimorbidity using Canadian
Nicole I Ketter1,2, Isabelle Rash1,2, Michelle C Yang1,2
1Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Insights
Males have a higher prevalence of cardiometabolic multimorbidity (CM), but females with CM report more depressive symptoms, pain, and daily living limitations. Understanding these sex differences in CM is crucial for targeted interventions.
Area of Science:
- Cardiology
- Endocrinology
- Gerontology
- Public Health
Background:
- Cardiometabolic multimorbidity (CM), defined as two or more conditions including stroke, diabetes, and heart disease, is rising.
- CM is associated with significantly increased mortality risk.
- Existing research indicates sex-based differences in disability outcomes for individual cardiometabolic diseases, suggesting similar disparities may exist for CM.
Purpose of the Study:
- To investigate sex differences in the prevalence of cardiometabolic multimorbidity (CM).
- To examine sex-based disparities in various disability indicators among individuals diagnosed with CM.
- To determine the predicted probabilities of disability in individuals with and without CM, stratified by sex.
Main Methods:
- Secondary analysis of data from the Canadian Longitudinal Study on Aging (CLSA).
- The CLSA dataset comprised a stratified, random sample of approximately 51,000 participants aged 45-85.
- Key independent variables included depressive symptoms, pain, hypertension, vision impairment, limitations in activities of daily living (ADL), and social participation.
Main Results:
- The study analyzed a weighted population of over 13.2 million individuals, with 659,621 having CM.
- Males constituted 62% of individuals with CM, indicating a higher prevalence compared to females.
- Females with CM reported higher probabilities of depressive symptoms (29% vs. 21%), pain (49% vs. 41%), and ADL limitations (27% vs. 11%) than males. Males with CM reported greater infrequent social participation (23% vs. 18%).
Conclusions:
- This research highlights significant sex-based differences in the reporting of disability variables among individuals with cardiometabolic multimorbidity (CM).
- The findings underscore the need to consider sex as a critical factor in understanding and managing CM.
- These insights can guide the development of sex-specific interventions to improve health outcomes for individuals with CM.
Background:
Cardiometabolic multimorbidity (CM), two or more of stroke, diabetes, and heart disease is increasing in prevalence and associated with a multiplicative mortality risk. Sex differences exist in disability outcomes for those with stroke, diabetes, and heart disease, and thus are likely for those with CM.
Objectives:
To assess 1) sex differences in the prevalence of CM, 2) sex differences in disability variables amongst those with CM, and 3) the predicted probabilities of disability among people with and without CM by sex.
Methods:
A secondary analysis using data from the Canadian Longitudinal Study on Aging (CLSA). The CLSA included a stratified, random sample of approximately 51,000 participants aged 45 to 85 at recruitment. Independent variables include depressive symptoms, pain, high blood pressure, eyesight, limitations with activities of daily living (ADL), and social participation.
Results:
A weighted population of 13,204,82 participants were included, 659,621 had CM. Males had a higher prevalence of CM than females, accounting for 62% of those with CM. Females with CM had a higher probability than males of reporting high depressive symptoms (females: 29% [95%CI:27%-31%], males: 21% [95%CI:19%-23%]), pain (females: 49% [95%CI:47%-52%], males: 41% [95%CI:39%-43%]), and limitations with ADL (females: 27% [95%CI:25%-29%], males: 11% [95%CI:10%-13%]) Males with CM had a higher probability than females of reporting infrequent social participation (females: 18% [95%CI:16%-20%], males: 23% [95%CI:21%-25%]).
Conclusion:
This study provides evidence on sex differences in the likelihood of reporting disability variables in individuals with CM. These insights into sex differences can inform targeted interventions and improve patient outcomes.
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