Sex differences in associations between multimorbidity and physical function domains among community-dwelling adults in Singapore

Abstract

ObjectivesThe aims of the study were to identify the associations between multimorbidity and specific physical function domains among community-dwelling adults in Singapore, and to examine sex differences in the associations.MethodsThis study was conducted using baseline data of 1,940 participants in the Population Health Index Survey conducted in the Central Region of Singapore from November 2015 to November 2016. Physical function was assessed using the Function Component of the Late-life Function and Disability Instrument and compared between men and women. Multiple linear regressions were conducted to examine associations between multimorbidity and different physical function domains for all participants, and in men and women separately.ResultsThe prevalence of multimorbidity in the study population was 35.0% for adults aged 21 years and above, with no differences between men and women. Multimorbidity was associated with reduced upper extremity function, basic and advanced lower extremity function, and overall function in men and women after adjusting for demographic factors. Multimorbidity had a stronger association with advanced lower extremity function and overall physical function in women than in men.ConclusionsThe findings of this study indicate that multimorbidity is associated with physical function domains in men and women, and in particular advanced lower extremity for women. Effective community-based interventions need to be implemented to preserve physical function in individuals with multimorbidity to keep them functionally independent and physically active in the community. Additional focus on advanced lower extremity function for women is needed.

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

“…There is no strict definition of "middle-age" and studies have defined it as age between 40-65 years 22 or 45-64 years. 3,5,23 In our study, the lower age limit was defined as 40 years old as that is also the minimum age at which general health screening is recommended. 6 According to the Singapore census those aged 65 years and above are considered elderly 21 and hence the upper limit of our middle-age range was defined as 64 years old.…”

“…2,3 About 30-58% of middle-aged patients have multimorbidity, 2−4 and the absolute number of these patients may even exceed that of elderly patients. 3 A survey of the general population in Singapore found that 35% of middle-aged participants had multimorbidity 5 and although there are no official estimates in the Singapore primary care setting, the figure is likely to be higher. The prevalence of multimorbidity rises steeply in midlife and plateaus in those aged 75 years and above, 2 and this may be contributed by the growing emphasis on screening and early detection of chronic diseases.…”

Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore

“…Multimorbidity and disability, which are related to but also distinct from frailty [28,29], were commonly adjusted in studies examining the association between frailty and healthcare utilisation [8,13]. We controlled for multimorbidity as a dichotomous variable (yes / no) which was de ned as the presence of two or more of the following 17 chronic conditions: dyslipidemia, high blood pressure, diabetes, chronic kidney disease, heart attack / ischemic heart disease, heart failure, stroke / transient ischemic attack, asthma, chronic bronchitis / emphysema / chronic obstructive pulmonary disease, cancer, osteoarthritis / gout / rheumatoid arthritis, osteoporosis, depression, anxiety disorder, schizophrenia, dementia / Alzheimer's, and Parkinson's disease [20]. Disability, which was determined based on whether assistance was required in any of the ten activities of daily living (ADLs) (yes / no) measured using the Modi ed Barthel Index [30], was also controlled in the models.…”

Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore

“…The baseline data of PHI which were collected during November 2015 to November 2016 were used for this study. The sampling procedure and survey methodology of the baseline PHI study has been described elsewhere [19][20][21]. In brief, eligible participants (Singapore citizens or permanent residents, aged 21 years and above and lived in the selected housing unit for the past six months) staying in randomly selected household units in the Central Region of Singapore were identi ed via door-to-door visits by trained surveyors and one eligible household member was randomly selected using Kish grid [22].…”