Association between comorbid conditions and BADL/IADL disability in hypertension patients over age 45

Qian, Jiahui; Ren, Xiubao

doi:10.1097/md.0000000000004536

Cited by 36 publications

(38 citation statements)

References 34 publications

(34 reference statements)

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“…In line with other studies, age was identified as a major risk factor for a decline in IADL functioning (27–29). Even though we noticed a more prominent age effect on the decline in several IADL activities for persons with “no MCC” at inclusion, we were able to confirm the findings of other studies that multimorbidity imposes a risk for decline in IADL functioning (5,7,28,29). The trends illustrated that persons with “≥3 MCC” and “1–2 MCC” had higher levels of disability at inclusion that progressed over time with higher risks of disability in late life for the majority of activities.…”

Section: Discussionsupporting

confidence: 87%

Trends in Risk of Limitations in Instrumental Activities of Daily Living Over Age in Older Persons With and Without Multiple Chronic Conditions

Mueller‐Schotte

Zuithoff

Schouw

et al. 2019

The Journals of Gerontology: Series A

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BackgroundTo investigate trends over age by comorbidity status for the risk of limitations in individual activities of daily living for community-living older persons.MethodsA longitudinal population-based study was conducted in 9,319 community-living Dutch persons aged 60 years and older. Self-reported multiple chronic conditions (MCC) and nine instrumental activities of daily livings (IADLs) were assessed in 15 studies of the Dutch National Care for the Elderly Program (TOPICS-MDS). Risks of limitations in IADLs, odds ratios (per 5 years), and rate ratios (per 5 years) were calculated with mixed logistic and negative binomial regression models with age as the underlying timescale, stratified by number of MCC (no, 1–2, ≥ 3 MCC), and corrected for confounders.ResultsAt inclusion, the number of IADL limitations was highest for the “≥3 MCC” group (2.00 interquartile range [1.00–4.00]) and equal for “no MCC” or “1–2 MCC” (1.00 interquartile range [0.00–2.00]). Trends of individual IADLs depicted a higher risk in IADL limitation with increasing age over 2 years of follow-up, except for handling finances for the “no MCC” group. The longitudinal age effect on IADL limitations varied subject to MCC, being strongest for the “no MCC” group for most IADLs; grooming and telephone use were almost unaltered by age and MCC.ConclusionWe observed a decline in IADL functioning with increasing age over 2 years of follow-up in persons with and without MCC. The impact of MCC on IADL decline varied per IADL activity.

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Section: Discussionsupporting

confidence: 87%

Trends in Risk of Limitations in Instrumental Activities of Daily Living Over Age in Older Persons With and Without Multiple Chronic Conditions

Mueller‐Schotte

Zuithoff

Schouw

et al. 2019

The Journals of Gerontology: Series A

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“…Prior studies have shown that chronic multimorbidity is an established risk factor for disability [26][27][28][29]34]. Based on the data from the CHARLS (2013), Qian et al confirmed that chronic multimorbidity was associated with a 3.66-fold increased risk of disability in ADLs and a 2.00-fold increased risk of disability in IADLs among adults aged ≥ 45 years who had hypertension [35]. However, the contribution of SMM to disability was understudied in this study.…”

Section: Discussionsupporting

confidence: 48%

Prevalence of somatic-mental multimorbidity and its prospective association with disability among older adults in China

Wang

Gao

et al. 2020

Aging

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We aimed to identify prevalent somatic-mental multimorbidity (SMM) and examine its prospective association with disability among a nationally representative sample. A total of 6728 participants aged 60 years and older in the China Health and Retirement Longitudinal Study were included. A total of 14 somatic or mental conditions were assessed in 2013. SMM was defined as any combination of two or more conditions in which at least one condition was somatic and at least one condition was mental. Disability risk was measured using the combined Activities of Daily Living (ADL)-Instrumental Activities of Daily Living (IADL) index (range 0-11; higher index indicates higher disability) in 2013 and 2015. Overall, the prevalence of SMM was 35.7% (95% confidence interval (CI): 34.1%-37.3%) in 2013. After adjustment for sociodemographic characteristics, lifestyles and baseline ADL-IADL index, over a maximum follow-up period of 2 years, SMM was associated with a 2.61 (95% CI: 2.12-3.22)-fold increase in ADL-IADL disability risk compared with that of healthy participants. In conclusion, SMM was prevalent in older Chinese adults, and it was associated with a higher risk of prospective disability.

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“…Diseases having clear manifestations of physical symptoms impact the activity of daily living of a patient more, than diseases like hypertension and diabetes. It is evident that, such physical symptoms like pain in joints or breathing problem affects an individual’s activities thus impairing the quality of life[ 49 ]. Our study also reveals the high functional limitation accruing from musculoskeletal disorders, which advocates for availability for the musculoskeletal care in primary care setting in India.…”

Section: Discussionmentioning

confidence: 99%

Pattern and severity of multimorbidity among patients attending primary care settings in Odisha, India

et al. 2017

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Multimorbidity is increasingly the primary concern of healthcare systems globally with substantial implications for patient outcomes and resource cost. A critical knowledge gap exists as to the magnitude of multimorbidity in primary care practice in low and middle income countries with available information limited to prevalence. In India, primary care forms the bulk of the health care delivery being provided through both public (community health center) and private general practice setting. We undertook a study to identify multimorbidity patterns and relate these patterns to severity among primary care attendees in Odisha state of India. A total of 1649 patients attending 40 primary care facilities were interviewed using a structured multimorbidity assessment questionnaire. Multimorbidity patterns (dyad and triad) were identified for 21 chronic conditions, functional limitation was assessed as a proxy measure of severity and the mean severity score for each pattern, was determined after adjusting for age. The leading dyads in younger age group i.e. 18–29 years were acid peptic disease with arthritis/ chronic back ache/tuberculosis /chronic lung disease, while older age groups had more frequent combinations of hypertension + arthritis/ chronic lung disease/vision difficulty, and arthritis + chronic back ache. The triad of acid peptic disease + arthritis + chronic backache was common in men in all age groups. Tuberculosis and lung diseases were associated with significantly higher age-adjusted mean severity score (poorer functional ability). Among men, arthritis, chronic backache, chronic lung disease and vision impairment were observed to have highest severity) whereas women reported higher severity for combinations of hypertension, chronic back ache and arthritis. Given the paucity of studies on multimorbidity patterns in low and middle income countries, future studies should seek to assess the reproducibility of our findings in other populations and settings. Another task is the potential implications of different multimorbidity clusters for designing care protocols, as currently the protocols are disease specific, hardly taking comorbidity into account.

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Association between comorbid conditions and BADL/IADL disability in hypertension patients over age 45

Cited by 36 publications

References 34 publications

Trends in Risk of Limitations in Instrumental Activities of Daily Living Over Age in Older Persons With and Without Multiple Chronic Conditions

Trends in Risk of Limitations in Instrumental Activities of Daily Living Over Age in Older Persons With and Without Multiple Chronic Conditions

Prevalence of somatic-mental multimorbidity and its prospective association with disability among older adults in China

Pattern and severity of multimorbidity among patients attending primary care settings in Odisha, India

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