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

Storeng, Siri Høivik; Vinjerui, Kristin Hestmann; Sund, Erik R.; Krokstad, Steinar

doi:10.1186/s12877-020-1425-3

Cited by 52 publications

(50 citation statements)

References 53 publications

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“…Furthermore, requiring these multiple conditions to be present in separate body systems identifies multimorbidity that is likely to require care from several specialists, which has been termed complex multimorbidity [20]. Such complex multimorbidity presented a moderate relationship with mortality, adjusted for sociodemographic characteristics, in a study on individuals aged 60 to 69 years in Norway [21].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study

Vinjerui

Bjorngaard

Krokstad

et al. 2020

JCM

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Multimorbidity and socioeconomic position are independently associated with mortality. We investigated the association of occupational position and several multimorbidity measures with all-cause mortality. A cohort of people aged 35 to 75 years who participated in the Trøndelag Health Study in 2006–2008 and had occupational data was linked to the Norwegian National Population Registry for all-cause mortality from study entry until 1 February 2019. Logistic regression models for each occupational group were used to analyze associations between the number of conditions and 10-year risk of death. Cox regression models were used to examine associations between combinations of multimorbidity, occupational position, and mortality. Analyses were conducted for men and women. Included were 31,132 adults (16,950 women (54.4%)); occupational groups: high, 7501 (24.1%); low, 15,261 (49.0%)). Increased mortality was associated with lower occupational group, more chronic conditions, and all multimorbidity measures. The joint impact of occupational group and multimorbidity on mortality was greater in men than women. All multimorbidity measures are strongly associated with mortality, with varying occupational gradients. Social differences in multimorbidity are a public health challenge and necessitate consideration in health care. Men in lower occupational groups seem to be a particularly vulnerable group.

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Section: Introductionmentioning

confidence: 99%

Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study

Vinjerui

Bjorngaard

Krokstad

et al. 2020

JCM

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“…In addition, we derived a three-category variable to capture multimorbidity (‘no multimorbidity’ = 0–1 conditions; ‘simple multimorbidity’ = 2–3 conditions; and ‘complex multimorbidity’ = 4 + conditions). Previous research has shown that differentiating between simple and complex multimorbidity can better capture the variability in multimorbidity in older adults 28 , 29 . ADLs 30 included walking across the room, dressing, bathing and showering, eating, and getting in and out of bed.…”

Section: Methodsmentioning

confidence: 99%

A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study

Carr

Federman

Dzahini

et al. 2021

Sci Rep

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Polypharmacy is commonly defined based on the number of medications taken concurrently using standard cut-offs, but several studies have highlighted the need for a multidimensional assessment. We developed a multidimensional measure of polypharmacy and compared with standard cut-offs. Data were extracted for 2141 respondents of the 2007 Prescription Drug Survey, a sub-study of the Health Retirement Study. Latent classes were identified based on multiple indicators of polypharmacy, including quantity, temporality and risk profile. A four-class model was selected based on fit statistics and clinical interpretability: ‘High risk, long-term’ (Class 1), ‘Low risk, long-term’ (Class 2), ‘High risk, short-term’ (Class 3), and ‘High risk for drug interactions, medium-term, regular’ (Class 4). Classes differed regarding sex, cohabitation, disability and multimorbidity. Participants in the ‘low risk’ class tended to be male, cohabitating, and reported fewer health conditions, compared to ‘high risk’ classes. Polypharmacy classes were compared to standard cut-offs (5+ or 9+ medications) in terms of overlap and mortality risk. The three ‘high risk’ classes overlapped with the groups concurrently taking 5+ and 9+ medications per month. However, the multidimensional measure further differentiated individuals in terms of risk profile and temporality of medication taking, thus offering a richer assessment of polypharmacy.

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“…In addition, it estimates direct effects mediated by other factors that integrate the causal network of outcomes of interest (10)(11) . Thus, given the results of the studies with this theme (1,(3)(4)(5)(6)(7)(8)(9) , it is assumed that functional disability results from sociodemographic, economic, clinical and behavioral characteristics of the older adult. However, there are doubts about which of these factors act directly or through mediation.…”

Section: Introductionmentioning

confidence: 99%

“…In a meta-analysis, it was observed that low physical performance and reduction of strength and muscle mass were associated with functional dependence ( 8 ) . It is noteworthy that, in a cohort in Norway, older adults with complex comorbidities have higher risks of dependence in the ADLs and of mortality ( 9 ) .…”

Section: Introductionmentioning

confidence: 99%

Using structural equation modeling in the understanding of functional disability in older adults

Tavares

Oliveira

Marmo

et al. 2021

Rev. Latino-Am. Enfermagem

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Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.

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

Cited by 52 publications

References 53 publications

Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study

Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study

A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study

Using structural equation modeling in the understanding of functional disability in older adults

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