Multimorbidity and functional decline in community-dwelling adults: a systematic review

Ryan, Áine; Wallace, Emma; O’Hara, Paul; Smith, Susan M

doi:10.1186/s12955-015-0355-9

Cited by 284 publications

(274 citation statements)

References 62 publications

(75 reference statements)

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“…However, multimorbidity is an important risk concept, as it has been associated with functional decline [12], worse quality of life [13], increased risk of premature mortality [14, 15], and increased healthcare costs [16]. In the largest study to date, people with schizophrenia in Scotland ( n = 9677) were significantly more likely to have two physical health comorbidities (OR = 1.37, 95% CI, 1.29–1.44) and three or more physical health comorbidities (OR = 1.19, 95% CI, 1.12–1.27) than general population controls [17].…”

Section: Introductionmentioning

confidence: 99%

Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries

Stubbs

Koyanagi

Veronese

et al. 2016

BMC Med

135

130

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BackgroundIn people with psychosis, physical comorbidities, including cardiovascular and metabolic diseases, are highly prevalent and leading contributors to the premature mortality encountered. However, little is known about physical health multimorbidity in this population or in people with subclinical psychosis and in low- and middle-income countries (LMICs). This study explores physical health multimorbidity patterns among people with psychosis or subclinical psychosis.MethodsOverall, data from 242,952 individuals from 48 LMICs, recruited via the World Health Survey, were included in this cross-sectional study. Participants were subdivided into those (1) with a lifetime diagnosis of psychosis (“psychosis”); (2) with more than one psychotic symptom in the past 12 months, but no lifetime diagnosis of psychosis (“subclinical psychosis”); and (3) without psychotic symptoms in the past 12 months or a lifetime diagnosis of psychosis (“controls”). Nine operationalized somatic disorders were examined: arthritis, angina pectoris, asthma, diabetes, chronic back pain, visual impairment, hearing problems, edentulism, and tuberculosis. The association between psychosis and multimorbidity was assessed by multivariable logistic regression analysis.ResultsThe prevalence of multimorbidity (i.e., two or more physical health conditions) was: controls = 11.4% (95% CI, 11.0–11.8%); subclinical psychosis = 21.8% (95% CI, 20.6–23.0%), and psychosis = 36.0% (95% CI, 32.1–40.2%) (P < 0.0001). After adjustment for age, sex, education, country-wise wealth, and country, subclinical psychosis and psychosis were associated with 2.20 (95% CI, 2.02–2.39) and 4.05 (95% CI, 3.25–5.04) times higher odds for multimorbidity. Moreover, multimorbidity was increased in subclinical and established psychosis in all age ranges (18–44, 45–64, ≥ 65 years). However, multimorbidity was most evident in younger age groups, with people aged 18–44 years with psychosis at greatest odds of physical health multimorbidity (OR = 4.68; 95% CI, 3.46–6.32).ConclusionsThis large multinational study demonstrates that physical health multimorbidity is increased across the psychosis-spectrum. Most notably, the association between multimorbidity and psychosis was stronger among younger adults, thus adding further impetus to the calls for the early intervention efforts to prevent the burden of physical health comorbidity at later stages. Urgent public health interventions are necessary not only for those with a psychosis diagnosis, but also for subclinical psychosis to address this considerable public health problem.

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Section: Introductionmentioning

confidence: 99%

Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries

Stubbs

Koyanagi

Veronese

et al. 2016

BMC Med

135

130

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“…multimorbidity, [20] is associated with the level of mobility disability in nursing home residents. [21] Preliminary results also indicate a relationship between mobility disability and the probability of a fall. [22][23][24] This phenomenon is particularly often reported in RCFs.…”

Section: Introductionmentioning

confidence: 81%

“…Most of the participants had two or three of the medical diagnoses recorded here, and were therefore multimorbid. [21] With regard to the disability of the mobility of the participants, the medical diagnosis is not insignificant as a possible causative parameter. Based on the data presented in this study, it will be possible in future evaluations to correlate the quality of mobility disability with the individual medical diagnoses of the participants using a multinomial logistic regression.…”

Section: Descriptionmentioning

confidence: 99%

Prevalence of mobility disabilities in nursing home residents and the association with age, BMI, fall risk and social participation

Fehling¹,

Dassen²

2017

JNEP

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Background and aim: Physical mobility is often described as a basic prerequisite for independence, self-determination, and social participation. Older people, particularly those in long-term care facilities, are more often affected by the loss of their mobility. However, the prevalence of the mobility disabilities of nursing home residents and their association with demographic and care-specific/medical factors have so far been studied less. This prevalence study should investigate a possible association of mobility disability with age, BMI, multimorbidity, fall risk, and social participation. Methods: The prevalence study covered the data of residents in 30 German residential care facilities (RCFs). Trained staff nurses used a standardised instrument to collect data about the age, obesity, medical diagnoses, the fall risk, the level of mobility disability, and the need for supporting the social participation of the residents. Results: The representative sample included 2,066 nursing home residents, of whom 81.5% required support in their mobility. The level of a mobility disability or the need for a support in matters of mobility by others was not associated either with age, with the BMI, or with the fall risk of the participants. The groups with higher mobility disability included the more multimorbid participants with more difficult medical diagnoses, and these had a higher need for support in their social participation. Conclusions: It may be that professional care must reflect the premature link between older and obese patients with mobility disability. In addition to nursing diagnoses, medical diagnoses should necessarily be integrated into the nursing assessment. The association between the level of mobility disability and the fall risk, which is often mentioned in the literature, should be critically reflected. Nursing home residents should be informed that there is a possible association between their mobility disability and their social participation.

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“…Multiple long term conditions are associated with a wide range of adverse outcomes for individuals and the health system. These included: increased health service use (14,56,79,(89)(90)(91)(92), polypharmacy (56,90,(93)(94)(95)(96), hospital admissions (14,79,89,90,97,98), out-of-pocket expenses (99-103), and psychological distress (79,93,(104)(105)(106), along with reductions in physical functioning (79,(107)(108)(109)(110)(111)(112), quality-of-life (14,79,(113)(114)(115)(116)(117), employability (118)(119)(120),and continuity of care (56,93,121,122).…”

Section: Prevalence and Impactmentioning

confidence: 99%

“…Such changes are often difficult to implement as individuals with multiple chronic conditions, experience greater disability and physical impairment than is generally associated with one condition (73,79,93,(111)(112)(113)192,193,212).…”

Section: Lifestyle Change Burdenmentioning

confidence: 99%

Is Australian primary care practice equipped to provide multimorbidity care?

Young¹

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Multimorbidity and functional decline in community-dwelling adults: a systematic review

Cited by 284 publications

References 62 publications

Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries

Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries

Prevalence of mobility disabilities in nursing home residents and the association with age, BMI, fall risk and social participation

Is Australian primary care practice equipped to provide multimorbidity care?

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