Morbidity, Comorbidity, and Their Association With Disability Among Community-Dwelling Oldest-Old in Israel

Fuchs, Z; Blumstein, Tzvia; Novikov, Ilya; Walter-Ginzburg, Adrian; Lyanders, Michael; Gindin, Jacob; Habot, Beni; Modan, Baruch

doi:10.1093/gerona/53a.6.m447

Cited by 90 publications

(73 citation statements)

References 29 publications

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“…Of these 25 publications, 4 were excluded because they did not contain prevalence information or data allowing its calculation. The fi nal sample used for data extraction and calculations was thus 21 articles: 8 containing prevalence information in primary care, 1,2,[12][13][14][15][16][17] 12 in the general population, [18][19][20][21][22][23][24][25][26][27][28][29] and 1 in both settings.…”

Section: Articles Included In the Reviewmentioning

confidence: 99%

“…The 2 studies looking at broad age ranges reported increasing numbers of chronic conditions with advancing age. 1,13 General Population Studies of the general population reported either national or local prevalence of multimorbidity in the United States, 22,24,27,29 Canada, 25,28 Israel, 26 Ireland, 23 Germany, 21 Sweden, 19 the Netherlands, 30 and Spain. 18 One article gathered data from sites in Finland, Italy, Table 2 shows the characteristics of articles reporting prevalence estimates of 2 or more coexisting chronic conditions in the general population.…”

Section: Primary Care Settingsmentioning

confidence: 99%

“…Participants consisted of national random samples, 18,22,[24][25][26][27][28][29] cohorts in particular geographic locations, [19][20][21]30 or individuals identifi ed from national pharmacy claims databases. 23 The sample size again varied widely, from 1,099 to 316,928 individuals.…”

Section: Primary Care Settingsmentioning

confidence: 99%

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A Systematic Review of Prevalence Studies on Multimorbidity: Toward a More Uniform Methodology

Fortin

Stewart²,

Poitras³

et al. 2012

The Annals of Family Medicine

889

957

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PURPOSEWe sought to identify and compare studies reporting the prevalence of multimorbidity and to suggest methodologic aspects to be considered in the conduct of such studies. METHODSWe searched the literature for English-and French-language articles published between 1980 and September 2010 that described the prevalence of multimorbidity in the general population, in primary care, or both. We assessed quality of included studies with a modifi ed version of the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Results of individual prevalence studies were adjusted so that they could be compared graphically. RESULTSThe fi nal sample included 21 articles: 8 described studies conducted in primary care, 12 in the general population, and 1 in both. All articles were of good quality. The largest differences in prevalence of multimorbidity were observed at age 75 in both primary care (with prevalence ranging from 3.5% to 98.5% across studies) and the general population (with prevalence ranging from 13.1% to 71.8% across studies). Apart from differences in geographic settings, we identifi ed differences in recruitment method and sample size (primary care: 980-60,857 patients; general population: 1,099-316,928 individuals), data collection, and the operational defi nition of multimorbidity used, including the number of diagnoses considered (primary care: 5 to all; general population: 7 to all). This last aspect seemed to be the most important factor in estimating prevalence. CONCLUSIONSMarked variation exists among studies of the prevalence of multimorbidity with respect to both methodology and fi ndings. When undertaking such studies, investigators should carefully consider the specifi c diagnoses included and their number, as well as the operational defi nition of multimorbidity.

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Section: Articles Included In the Reviewmentioning

confidence: 99%

Section: Primary Care Settingsmentioning

confidence: 99%

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A Systematic Review of Prevalence Studies on Multimorbidity: Toward a More Uniform Methodology

Fortin

Stewart²,

Poitras³

et al. 2012

The Annals of Family Medicine

889

957

View full text Add to dashboard Cite

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“…2 It is estimated that 57 million Americans had multiple chronic conditions in 2000 and that this number will rise to 81 million by 2020. 3 A few studies have estimated the prevalence of multimorbidity in Europe, 4,5 the Middle East, 6 the United States, [7][8][9] and Canada. 10 Table 1 summarizes the prevalence data found in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…There are, however major differences in the sources and results of these studies. [4][5][6][7][8][9][10] The data were obtained from various surveys, [8][9][10] administrative databases, 7 or computerized networks of family practices. 4,5 None of these reports includes prevalence data obtained from a review of medical records, although some have suggested that this strategy is the best way to collect information about medical diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Multimorbidity Among Adults Seen in Family Practice

Fortin

Bravo²,

Hudon³

et al. 2005

The Annals of Family Medicine

818

678

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PURPOSE There are few valid data that describe the extent of multimorbidity in primary care patients. The purpose of this study was to estimate its prevalence in family practice patients by counting the number of chronic medical conditions and using a measure that considers the severity of these conditions, the Cumulative Illness Rating Scale (CIRS). METHODSThe study was carried out in the Saguenay region (Québec, Canada) in 2003. The participation of adult patients from 21 family physicians was solicited during consecutive consultation periods. A research nurse reviewed medical records and extracted the data regarding chronic illnesses. For each chronic condition, a severity rating was determined in accordance with the CIRS scoring guidelines. RESULTSThe sample consisted of 320 men and 660 women. Overall, 9 of 10 patients had more than 1 chronic condition. The prevalence of having 2 or more medical conditions in the 18-to 44-year, 45-to 64-year, and 65-year and older age-groups was, respectively, 68%, 95%, and 99% among women and 72%, 89%, and 97% among men. The mean number of conditions and mean CIRS score also increased signifi cantly with age.CONCLUSIONS Whether measured by simply counting the number of conditions or using the CIRS, the prevalence of multimorbidity is quite high and increases signifi cantly with age in both men and women. Patients with multimorbidity seen in family practice represent the rule rather than the exception.

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Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?

2010

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Many people living with chronic conditions have multiple chronic conditions. Multimorbidity is defined here as the co-existence of two or more chronic conditions, where one is not necessarily more central than the others. Multimorbidity affects quality of life, ability to work and employability, disability and mortality. Currently, clinicians have limited guidance or evidence as to how to approach care decisions for such patients. Understanding how to best care and design the health system for patients with multimorbidity may lead to improvements in quality of life, utilization of healthcare, safety, morbidity and mortality. The objective of this paper is to review the implications of multimorbidity for the design of health system and to understand the research needs for this population. The consideration of people with multimorbidity is essential in the design and evaluation of health systems. Fundamentally, people with multimorbidity should receive a patient -and family-centered approach to care throughout the health system, and understanding how to deliver this type of care in effective and efficient ways is an enormous challenge, and opportunity, for clinicians, researchers, and policy makers today.

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Morbidity, Comorbidity, and Their Association With Disability Among Community-Dwelling Oldest-Old in Israel

Abstract: The identification of medical conditions and sociodemographic variables related to limitations in functioning may serve as a basis for health promotion and disease prevention in elders by attempting to reduce the incidence and disabling consequences of known disabling conditions.

Cited by 90 publications

References 29 publications

A Systematic Review of Prevalence Studies on Multimorbidity: Toward a More Uniform Methodology

A Systematic Review of Prevalence Studies on Multimorbidity: Toward a More Uniform Methodology

Prevalence of Multimorbidity Among Adults Seen in Family Practice

Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?

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