The mediating effect of pain on the association between multimorbidity and disability and impaired physical performance among community-dwelling older adults in southern China

Peng, Xin; Bao, Xinyu; Xie, YiXian; Zhang, Xiaoxia; Huang, Junhai; Liu, Yan; Cheng, Mengjiao; Liu, Nan; Wang, Peixi

doi:10.1007/s40520-019-01324-1

Cited by 29 publications

(24 citation statements)

References 45 publications

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“…Similar data were found in a study conducted in Scotland with older adults over 65 years of age in the general population [ 46 ]. Older adults with multimorbidity had a worse functional profile, and this finding was is in line with those of other studies with older adults [ 23 , 47 ]. Participants with diseases of the nervous system, including dementias, had a worse functional profile and greater cognitive impairment and thus more dependence.…”

Section: Discussionsupporting

confidence: 93%

The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study

et al. 2021

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Background The aging population and its associated health needs require specific nursing care. The aim of this study was to draw an epidemiological profile of Portuguese elderly adults attending in residential homes and day centers and to evaluate the association between the functioning and cognition of these older adults and their sociodemographic characteristics and presence of multimorbidity. Methods This was a cross-sectional study of 613 older adults. Functioning was assessed using the Elderly Nursing Core Set, and cognition was assessed using the Mini Mental State Examination. Descriptive and inferential analyses were performed. Results The mean age was 85.73 years; the majority of the participants were female (69.3 %), widowed (67.0 %) and over 85 years old (60.4 %). A total of 68.2 % of the sample presented multimorbidity. A total of 54.5 % had cognitive impairment, and the average functional profile was classified as “moderate difficulty”. Institutionalized older adults had more diseases than those who attended the day center. Women, those who were illiterate, those who were institutionalized and older adults who had diseases of the nervous system had a worse functional profile and greater cognitive impairment. Those with multimorbidity had a worse functional profile, and those without a spouse had greater cognitive impairment. Conclusions Given the functional and cognitive profile of older adults, it is necessary to adopt care practices focused on the rehabilitation/maintenance of self-care and affective relationships. This care must be provided by highly qualified professionals. Therefore, it is necessary to increase the ratio of nurses per older adult in these institutions.

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Section: Discussionsupporting

confidence: 93%

The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study

et al. 2021

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“…The current study demonstrated that women more often being lower educated, living alone and having chronic diseases, pain and depressive symptoms compared to men contributes to the lower observed gait speed among women compared to men (exposure theory). Tseng et al demonstrated that the higher prevalence of chronic diseases among older women did not contribute to the sex difference in gait speed [ 17 ], while the current study and others [ 34 ] suggest it does contribute. The discrepancy with Tseng et al might be due to their individual testing of chronic health conditions, which might limit the statistical contributing effect of chronic diseases overall.…”

Section: Discussioncontrasting

confidence: 56%

“…As physical activity, BMI and pain are inter-correlated [ 32 – 34 ], a multifactorial pathway may exist. For example, there are various mechanisms for obesity-related pain and pain can also lead to an increase in BMI through a physically inactive lifestyle among older adults [ 32 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute?

et al. 2021

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Background This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men. Methods Data from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55–81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3–4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) socio-demographic, lifestyle, social and health determinants of gait speed. Results Women had a 0.054 m/s (95 % CI: 0.076 − 0.033, adjusted for height and age) lower mean gait speed compared to men. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men (i.e. higher exposure). Conclusions Both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. The identified (modifiable) contributing factors should be taken into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking.

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“…A sex-specific age–period–cohort study conducted in Hongkong showed ( 40 ) that there was an upward inflection of the risk of increased morbidity burden. As it is shown, the disparity between the north and the south became narrow over time ( 24 , 41 , 42 ). It urges the need to find out the mechanism how geographic characteristics impact on the progression of multimorbidity among the elderly.…”

Section: Discussionmentioning

confidence: 91%

Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

et al. 2022

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BackgroundMultimorbidity presents an enormous problem to societal and healthcare utilization under the context of aging population in low- and middle-income countries (LMICs). Currently, systematic studies on the profile of multimorbidity and its characteristics among Chinese elderly are lacking. We described the temporal and spatial trends in the prevalence of multimorbidity and explored chronological changes of comorbidity patterns in a large elderly population survey.MethodsData were extracted from the Chinese Longitudinal Healthy Longevity Study (CLHLS) conducted between 1998 and 2018 in a random selection of half of the counties and city districts. All the elderly aged 65 and older were included in the survey of eight waves. We used 13 investigated chronic diseases to measure the prevalence of multimorbidity by means of geography, subpopulation, and chronological changes. The patterns of multimorbidity were assessed by computing the value of relative risk (RR indicates the likelihood of certain diseases to be associated with multimorbidity) and the observed-to-expected ratio (O/E indicates the likelihood of the coexistence of a multimorbidity combination).ResultsFrom 1998 to 2018, the prevalence of multimorbidity went from 15.60 to 30.76%, increasing in the fluctuation across the survey of eight waves (pfor trend = 0.020). Increasing trends were observed similarly in a different gender group (pmale = 0.009; pfemale = 0.004) and age groups among female participants (p~80 = 0.009; p81−90 = 0.004; p91−100 = 0.035; p101~ = 0.018). The gap in the prevalence of multimorbidity between the north and the south was getting narrow across the survey of eight waves. Hypertension was the highest prevalent chronic condition while diabetes was most likely to coexist with other chronic conditions in the CLHLS survey. The most frequently occurring clusters were hypertension and heart disease, hypertension and cataract, and hypertension and chronic lung disease. And, the cancer, TB, and Parkinson's disease cluster took the domination of O/E rankings over time, which had a higher probability of coexistence in all the multimorbidity combinations.ConclusionsThe prevalence of multimorbidity has been increasing nationwide, and more attention should be paid to a rapid growth in the southern part of China. It demands the effective diagnosis and treatment adopted to the highly prevalent comorbidities, and strategies and measures were adjusted to strongly relevant clusters.

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The mediating effect of pain on the association between multimorbidity and disability and impaired physical performance among community-dwelling older adults in southern China

Cited by 29 publications

References 45 publications

The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study

The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study

The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute?

Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

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