Associations between prevalent multimorbidity combinations and prospective disability and self-rated health among older adults in Europe

作者：Paige E. Sheridan, Christine A. Mair, Ana Romàn Quiñones · 发表于：BMC Geriatrics · 年份：2019 · DOI：10.1186/s12877-019-1214-z · 被引用次数：119 · 研究领域：Chronic Disease Management Strategies、Diabetes Management and Education、Health disparities and outcomes

BACKGROUND: Multimorbidity is associated with greater likelihood of disability, health-related quality of life, and mortality, greater than the risk attributable to individual diseases. The objective of this study is to examine the association between unique multimorbidity combinations and prospective disability and poor self-rated health (SRH) in older adults in Europe. METHODS: We conducted a prospective analysis using data from the Survey of Health, Ageing and Retirement in Europe in 2013 and 2015. We used hierarchical models to compare respondents with multiple chronic conditions to healthy respondents and respondents reporting only one chronic condition and made within-group comparisons to examine the marginal contribution of specific chronic condition combinations. RESULTS: Less than 20% of the study population reported having zero chronic conditions, while 50% reported having at least two chronic conditions. We identified 380 unique disease combinations among people who reported having at least two chronic conditions. Over 35% of multimorbidity could be attributed to five specific multimorbidity combinations, and over 50% to ten specific combinations. Overall, multimorbidity combinations that included high depressive symptoms were associated with increased odds of reporting poor SRH, and increased rates of ADL-IADL disability. CONCLUSIONS: Multimorbidity groups that include high depressive symptoms may be more disabling than combinations that include only somatic condi...