Multimorbidity and Functional Limitations Among Adults 65 or Older, NHANES 2005–2012

Abstract

IntroductionThe development of functional limitations among adults aged 65 or older has profound effects on individual and population resources. Improved understanding of the relationship between functional limitations and co-occurring chronic diseases (multimorbidity) is an emerging area of interest. The objective of this study was to investigate the association between multimorbidity and functional limitations among community-dwelling adults 65 or older in the United States and explore factors that modify this association.MethodsWe conducted a cross-sectional analysis of adults aged 65 or older using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2012. We used negative binomial regression to estimate the association between multimorbidity (≥2 concurrent diseases) and functional limitations and to determine whether the association differed by sex or age.ResultsThe prevalence of multimorbidity in this population was 67% (95% confidence interval [CI], 65%–68%). Each additional chronic condition was associated with an increase in the number of functional limitations, and the association was stronger among those aged 75 or older than among those aged 65 to 74. For those aged 65 to 74, each additional chronic condition was associated with 1.35 (95% CI, 1.27–1.43) times the number of functional limitations for men and 1.62 times (95% CI, 1.31–2.02) the number of functional limitations for women. For those 75 or older, the associations increased to 1.71 (95% CI, 1.35–2.16) for men and 2.06 (95% CI, 1.51–2.81) for women for each additional chronic condition.ConclusionMultimorbidity was associated with increases in functional limitations, and the associations were stronger among women than among men and among adults aged 75 or older than among those aged 65 to 74. These findings underscore the importance of addressing age and sex differences when formulating prevention strategies.

Multimorbidity in Middle-Aged Adults with Cerebral Palsy

“…Indeed, the overall prevalence of multimorbidity in our cohort was nearly 60%, which is only slightly lower than that recently reported for adults 65 years old and older (67%) without cerebral palsy, 22 and significantly higher than that reported for middle-aged men (40–49 years: 20.4%; 50–59 years: 38.1%) and women (40–49 years: 19.7%; 50–59 years: 35.8%) without cerebral palsy. 23 However, we caution the comparability between studies, because there is no current consensus on the number and type of conditions to be considered, the source of diagnoses, and the window of capture for chronic disease clustering.…”

Patterns of Multimorbidity in Adults: An Association Rules Analysis Using the Korea Health Panel

“…Multimorbidity is often associated with functional limitation, reduced quality of life, higher mortality, polypharmacy and high treatment burden, higher rates of adverse drug events, and frequent use of health services [19,20]. The National Institute for Health and Care Excellence (NICE) [21] recommended that the multimorbidity approach should go beyond the benefits and risks of the guidelines for single health conditions, while focusing on the interaction between health conditions and treatment and their effect on quality of life.…”

Associations between complex multimorbidity, activities of daily living and mortality among older Norwegians. A prospective cohort study: the HUNT Study, Norway

“…A systematic review from 2015 concluded that multimorbidity predicts future functional decline in adults, but comparisons between studies are hampered by the heterogeneity in definitions and operationalizations of multimorbidity and functional decline and the included cohort studies had short follow-up time (1-3 years) [9]. Later studies including four cross-sectional and two cohort studies with 1 and 2 years follow-up time have also found associations between multimorbidity and ADL/IADL disability [34][35][36][37][38]. It may seem that disease combinations including depression and cognitive impairment increase the risk for ADL/IADL disability substantially compared to combinations of only somatic disease [37,39].…”