Multimorbidity

Abstract

OBJECTIVE To evaluate the occurrence and factors associated with multimorbidity among Brazilians aged 50 years and over.METHODS This is a cross-sectional study in a nation-based cohort of the non-institutionalized population in Brazil. Data were collected between 2015 and 2016. Multimorbidity was assessed from a list of 19 morbidities, which were categorized into ≥ 2 and ≥ 3 diseases. The analysis included the calculation of frequencies and the most frequent 10 pairs and triplets of combinations of diseases. The crude and adjusted analyses evaluated the demographic, socioeconomic, behavioral, and contextual variables (area of residence, geopolitical region, and coverage of the Family Health Strategy) using Poisson regression.RESULTS From the total of 9,412 individuals, 67.8% (95%CI 65.6–69.9) and 47.1% (95%CI 44.8–49.4) showed ≥ 2 and ≥ 3 diseases, respectively. In the adjusted analysis, women, older persons, and those who did not consume alcohol had increased multimorbidity. There were no associations with race, area of residence, geopolitical region, and coverage of the Family Health Strategy. The 10 pairs (frequencies observed between 11.6% and 23.2%) and the 10 triplets (frequencies observed between 4.9% and 9.5%) of the most frequent diseases mostly included back problems (15 times) and systemic arterial hypertension (11 times). All combinations were statistically higher than expected by chance.CONCLUSIONS The occurrence of multimorbidity was high even among younger individuals (50 to 59 years). Approximately two in three (≥ 2 diseases) and one in two (≥ 3 diseases) individuals aged 50 years and over presented multimorbidity, which represents 26 and 18 million persons in Brazil, respectively. We observed high frequencies of combinations of morbidities.

Hemovigilance and patient safety: analysis of immediate transfusion reactions in elderly

“…Due to the progressive and dynamic sequential changes in the aging process, which are often followed by functional disabilities, weaknesses, vulnerability, and by the increased longevity of the population, individuals not only have become more susceptible to noncommunicable diseases (such as cancer, cardiovascular and respiratory diseases), but also to acute events of these or other pre-existing conditions, being affected by functional limitations and hospitalizations (4)(5)(6)(7)(8)(9)(10)(11) .…”

Prospective GERiatric Observational (ProGERO) Study: cohort design and preliminary results

“…In comparison with other cohort studies of older adults in São Paulo [40][41][42][43], Brazil [3,[44][45][46] and LMICs [47][48][49][50][51][52], our participants were older, had a more signi cant burden of disease, and a higher prevalence of frailty ( Table 3). The result was expected since our sample is mostly comprised of multimorbid older adults, followed in an academic medical center.…”

“…ELSI-Brazil allows investigations of the aging process, its health, psychosocial and economic determinants, and societal consequences. The baseline examination was conducted in 2015-2016[3,[44][45][46]. SABE: The health, well-being and aging project was coordinated by the Pan American Health Organization and aimed to collect information about the living conditions of the elderly population (aged 60 and older) in urban metropolitan areas in seven Latin American countries, and to investigate cohort, socioeconomic and gender differences in relation to health status, as well as use and access to health care.…”

Elderly vulnerability: concept development

“…As it is the most evident change, the prevalence of diseases among the elderly population favors the cultural conception of the human aging process, in which there is inevitably an accumulation of physical and cognitive diseases, as well as weaknesses. However, this stage of life should not be synonymous with morbidities, even when it culminates in the progressive loss of functions and severe limitations, as it is a period with its own characteristics and values (10) .…”

“…Therefore, it is increasingly necessary to consider the complexity inherent to the biological, social and psychological aging processes, which interact with each other and determine the heterogeneity of senescence. The elderly person must be seen individually, in order to identify how the physical, mental, social conditions, economic and functional resources determine their real demands and influence the quality of life (10)(11)(12)(13) .…”