Multimorbidity in Older Adults
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TLDR
Examination of population-based administrative claims data indicating specific health service delivery to nearly 31 million Medicare fee-for-service beneficiaries for 15 prevalent chronic conditions found 67% had multimorbidity, which increased with age, from 50% for persons under age 65 years to 62% for those aged 65-74 years.Abstract:
Multimorbidity, the coexistence of 2 or more chronic conditions, has become prevalent among older adults as mortality rates have declined and the population has aged. We examined population-based administrative claims data indicating specific health service delivery to nearly 31 million Medicare fee-for-service beneficiaries for 15 prevalent chronic conditions. A total of 67% had multimorbidity, which increased with age, from 50% for persons under age 65 years to 62% for those aged 65-74 years and 81.5% for those aged ≥85 years. A systematic review identified 16 other prevalence studies conducted in community samples that included older adults, with median prevalence of 63% and a mode of 67%. Prevalence differences between studies are probably due to methodological biases; no studies were comparable. Key methodological issues arise from elements of the case definition, including type and number of chronic conditions included, ascertainment methods, and source population. Standardized methods for measuring multimorbidity are needed to enable public health surveillance and prevention. Multimorbidity is associated with elevated risk of death, disability, poor functional status, poor quality of life, and adverse drug events. Additional research is needed to develop an understanding of causal pathways and to further develop and test potential clinical and population interventions targeting multimorbidity.read more
Citations
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What is polypharmacy? A systematic review of definitions
Nashwa Masnoon,Nashwa Masnoon,Sepehr Shakib,Sepehr Shakib,Lisa Kalisch-Ellett,Gillian E. Caughey,Gillian E. Caughey,Gillian E. Caughey +7 more
TL;DR: Numerical definitions of polypharmacy did not account for specific comorbidities present and make it difficult to assess safety and appropriateness of therapy in the clinical setting, according to a systematic review of existing literature.
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Health Outcomes Associated with Polypharmacy in Community-Dwelling Older Adults: A Systematic Review
Terri R. Fried,Terri R. Fried,John R. O'Leary,Virginia Towle,Mary K. Goldstein,Mary K. Goldstein,Mark Trentalange,Deanna K. Martin +7 more
TL;DR: Evidence regarding the health outcomes associated with polypharmacy, defined as number of prescribed medications, in older community‐dwelling persons, is summarized.
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Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model
TL;DR: Findings indicate that over the next 20 years there will be an expansion of morbidity, particularly complex multi-morbidity (4+ diseases), and advocate for a new focus on prevention of, and appropriate and efficient service provision for those with, complexMulti-Morbidity.
Journal ArticleDOI
The increasing burden and complexity of multimorbidity.
Anna J. Kone Pefoyo,Anna J. Kone Pefoyo,Susan E. Bronskill,Andrea Gruneir,Andrew Calzavara,Kednapa Thavorn,Kednapa Thavorn,Yelena Petrosyan,Colleen J. Maxwell,YuQing Bai,Walter P. Wodchis,Walter P. Wodchis +11 more
TL;DR: The high prevalence of multimorbidity and numerous combinations of conditions suggests that single, disease-oriented management programs may be less effective or efficient tools for high quality care compared to person-centered approaches.
Journal ArticleDOI
Multimorbidity and mortality in older adults: A systematic review and meta-analysis.
Bruno Pereira Nunes,Thaynã Ramos Flores,Gregore I. Mielke,Elaine Thumé,Luiz Augusto Facchini +4 more
TL;DR: Multimorbidity was associated with an increase in risk of death and adjusted analysis which includes potential confounders might contribute to better understanding of causal relationships between multimorbidities and mortality.
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