Geriatric syndromes, multimorbidity, and disability overlap and increase healthcare use among older Chinese

Abstract

BackgroundGeriatric syndromes, multimorbidity, and disability are prevalent among ageing population. However, no study empirically examined their additive or synergistic effect on healthcare use. The present study aims to estimate overlapping prevalence of geriatric syndromes, multimorbidity, and disability; and to examine associations of these three conditions with healthcare use.MethodsA cross-sectional study was conducted in community-dwelling older adults aged 60 and above in 12 Hong Kong districts. Pearson’s chi-squared test for trend was performed to examine prevalence of geriatric syndromes, multimorbidity, and disability across three age groups (60–69, 70–79, and ≥ 80). Multiple logistic regression was conducted to explore associations of these three conditions with three types of healthcare use (hospital admission, general outpatient clinic and specialist outpatient clinic attendance) respectively.ResultsAmong 2618 participants, 75.3, 41.8, and 22.5% had geriatric syndromes, multimorbidity, and disability respectively, and 10.4% had all the three conditions. Prevalence of the three conditions and their coexistence significantly increased with age (p for trend < .001). Each condition was independently associated with at least two out of three types of healthcare use. Interestingly, the associations of multimorbidity and disability with specialist outpatient clinic attendance were weakened at older age, while the associations of geriatric syndromes with hospital admission and specialist outpatient clinic attendance were strengthened. Furthermore, the odds of all the three types of healthcare use increased with the number of conditions present (p for trend < .001).ConclusionsOur findings support that the three conditions overlap and increase healthcare use. Early identification, prevention and intervention targeting older adults living with multiple healthcare needs are necessary.

A Multicenter Study of Multimorbidity in Older Adult Inpatients in China

“…Our study showed that the multimorbidity rate of older inpatients was higher among people living in northern areas of China than in the south. Surveys conducted in northern China reported a multimorbidity rate in older adults from 82% to 86.9%, compared with 41.8% to 49.4% in southern China (13,(38)(39)(40). This result could be due to differences in environmental factors and the fact that the lifestyles of older adults in southern China appear to be better than in the north, with people living in southern China having a lower BMI and sodium intake (41).…”

Multimorbidity in middle age predicts more subsequent hospital admissions than in older age: A nine-year retrospective cohort study of 121,188 discharged in-patients

“…It is possible that very old non-multimorbid patients suffered from severe frailty and had similar healthcare utilization as their multimorbid counterparts did. A local study of community living older people [44] showed that while number of chronic diseases was associated with use of hospital services in the preceding twelve months, geriatric syndromes per se without multimorbidity (such as sarcopenia, frailty, cognitive impairment) also increased use of hospital services to the same extent (increase of approximately 20%). These geriatric syndromes, notably frailty and cognitive impairment, together with a higher risk of medication-related adverse events and other hospital-related complications [45] in older patients might also suffice to explain the generally greater annual number of hospitalized days given the same multimorbidity status [46,47].…”

Effects of hearing impairment and hearing aid use on the incidence of cognitive impairment among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

“…It is well-known that older adults often suffer from multi-morbidities. A study showed that among 2618 participants, 75.3%, 41.8%, and 22.5% had geriatric syndromes, multimorbidity, and disability, respectively, and 10.4% had all the three conditions" [8]. Recently, researchers have tried to use model adjustment or mediation analyses to assess possible mediating pathways between HI and cognitive impairment.…”