Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA)

Fisher, Kathryn; Griffith, Lauren; Gruneir, Andrea; Kanters, David; Markle‐Reid, Maureen; Ploeg, Jenny

doi:10.1371/journal.pone.0255907

Cited by 19 publications

(15 citation statements)

References 74 publications

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“…limited, some data suggest that certain clusters, in particular those including mental health conditions (such as depression), are associated with poorer health 80,81 , functional limitations 82 and higher health-care costs compared with other clusters 83 . However, few replication studies have been carried out, and available studies suggest that observed condition clusters are not usually replicable using different methods and/or in different datasets 77,79,[84][85][86] .…”

Section: Complex Multimorbidity 5162mentioning

confidence: 99%

Multimorbidity

Skou

Mair

Fortin

et al. 2022

Nat Rev Dis Primers

443

283

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Interest in multimorbidity -commonly defined as the co-occurrence of at least two chronic conditions in the same individual 1 -has increased in the past few years owing to its substantial effect on the individual and the individual's family, as well as on health systems and on society, particularly in resource-poor settings 2-4 . Multimorbidity is distinct from the related concept of comorbidity, which refers to the combined effects of additional conditions in relation to the index condition in an individual [5][6][7][8] . By contrast, care for multimorbidity is patient-centred and does not routinely give priority to any single condition, although in clinical care, patients and clinicians will usually focus on the most pressing problems that the patient is experiencing.People with multimorbidity are more likely to die prematurely, be admitted to hospital and have an increased length of stay than people with a single chronic condition 9,10 . Multimorbidity is also associated with poorer function and health-related quality of life (HRQOL), depression and intake of multiple drugs (polypharmacy) and greater socioeconomic costs [11][12][13][14][15][16][17][18] . Most health care is designed to treat individual conditions rather than providing comprehensive, person-centred care 2,19,20 , which often leads to fragmented and sometimes contradictory care for people with multimorbidity and increases their treatment burden 21 Moreover, treating one condition at a time is inefficient and unsatisfactory for both people with multimorbidity and their health-care providers [22][23][24] .Multimorbidity is increasingly common owing to changes in lifestyle risk factors, notably physical inactivity and obesity, and population ageing that in part reflects improvements in survival from acute and chronic conditions 2,19,25,26 . Multimorbidity is associated with socioeconomic status and age 3,19,25,27 . However, although age is the strongest driver of multimorbidity, in absolute numbers, more people <65 years of age have multimorbidity than people ≥65 years of age, partly because more people in the general population are in that age group. Moreover, this emphasizes that multimorbidity is not just a feature of ageing 19,26 .Multimorbidity is further complicated in low-income and middle-income countries (LMICs) by the overlap of compounding factors, including adverse environmental and early life stressors linked to poverty, limited social infrastructure and poorer family coping mechanisms, that translate into chronic diseases occurring at earlier ages [28][29][30][31] . LMICs also have a higher prevalence of multimorbidity-related financial burden 32,33 and have weaknesses in health systems including a greater focus Treatment burdenThe workload associated with managing treatments and health-care recommendations and the impact of this on an individual and their supporters.

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Section: Complex Multimorbidity 5162mentioning

confidence: 99%

Multimorbidity

Skou

Mair

Fortin

et al. 2022

Nat Rev Dis Primers

443

283

View full text Add to dashboard Cite

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Section: Discussionmentioning

confidence: 99%

“…Several studies demonstrated that functional limitation is common in older adults and increases with age and health conditions, such as cardiopulmonary diseases, neurological conditions, diabetes mellitus, cancer, obesity, dementia, affective disorders and fractures [ 1 , 10 , 23 , 24 ]. In addition, the coexistence of two or more health conditions often creates more disability than would be expected [ 1 , 23 , 25 ]. In this study, the services presented a percentage of combination of comorbidities of 24% in GDH and 19% in GIFRU, and a mixture of clinical diagnoses, such as stroke, Parkinson’s, fractures and neurocognitive disorders.…”

Section: Discussionmentioning

confidence: 99%

Physical and Functional Clinical Profile of Older Adults in Specialized Geriatric Rehabilitation Care Services in Saguenay-Québec: A Retrospective Study at La Baie Hospital

Lima

Dallaire

Tremblay

et al. 2022

IJERPH

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Musculoskeletal disorders, cardiovascular and neurological diseases were the most commonly debilitating conditions and risk factors associated with pain, mobility limitations, increased risk of falls and disability. Studies barely address the profile of older adults in care within a specialized geriatric rehabilitation service (SGRS) to provide subsidies for new actions within the public healthcare to reduce falls and improve management in health investments. This study aimed to establish a clinical physical and functional profile of the patients with neuromusculoskeletal and cognitive disorders and fallers in interventions within SGRS. From a retrospective study design, 127 medical records were compiled and analyzed to determine the physical and functional profile of older adults and differences according to sex, age groups and the benefits for local physical therapy intervention. The users were between 76 and 85 years of age, with diverse clinical diagnoses and debilitating conditions and impairments. A higher proportion presented gait and balance impairments and had two or more falls in 12 months. A significant effect for advanced age was observed. Overall, real benefits were reported with intervention for functional improvement, although the absence of a control group. These results have direct implications for a better understanding of a local SGRS and provide subsidies for developing new approaches for the assessment and treatment of older adults with high a risk of falls in order to reduce costs for the public health system.

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“…Multimorbidity can be defined generically as the accumulation of two or more chronic health conditions [ 10 ]. The increasing prevalence of chronic diseases and the rapid ageing of the population has led to an increase in multimorbidity worldwide [ 11 , 12 ], making it one of the greatest challenges for healthcare systems [ 13 , 14 ]. This condition is associated with reduced quality-of-life, increased disability, functional impairment, increased healthcare utilization and fragmentation of care, complex treatment, and increased mortality [ 15 , 16 , 17 ], with the consequent increase in aspects such as health and social costs and poly-medication.…”

Section: Introductionmentioning

confidence: 99%

“…This condition is associated with reduced quality-of-life, increased disability, functional impairment, increased healthcare utilization and fragmentation of care, complex treatment, and increased mortality [ 15 , 16 , 17 ], with the consequent increase in aspects such as health and social costs and poly-medication. Additionally, there are strong associations between having multimorbidity and poorer mental and physical health outcomes [ 18 , 19 ] and a direct association between having multiple physical chronic diseases and consequent common mental disorders [ 12 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic

Carretero-Bravo

Ramos-Fiol

Ortega-Martín

et al. 2022

IJERPH

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Background: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities. Methods: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model. Results: We obtained a model with five patterns (entropy = 0.727): ‘Relative Healthy’, ‘Cardiometabolic’, ‘Musculoskeletal’, ‘Musculoskeletal and Mental’, and ‘Complex Multimorbidity’. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression. Conclusions: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments.

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Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA)

Cited by 19 publications

References 74 publications

Multimorbidity

Multimorbidity

Physical and Functional Clinical Profile of Older Adults in Specialized Geriatric Rehabilitation Care Services in Saguenay-Québec: A Retrospective Study at La Baie Hospital

Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic

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