Coexisting chronic conditions in the older population: Variation by health indicators

Published:March 01, 2016DOI:https://doi.org/10.1016/j.ejim.2016.02.014

      Highlights

      • There is variability in the indicators used to describe health in older persons.
      • Multimorbidity, polypharmacy, comorbidity index and complex problems were described.
      • 40% of people 60+ years did not meet the criteria for any of the 4 health indicators.
      • Among the others, prevalence of chronic conditions varied greatly by indicator used.
      • Different indicators are needed to capture health complexity in older adults.

      Abstract

      Background

      This study analyzes the prevalence and patterns of coexisting chronic conditions in older adults.

      Design

      Cross-sectional.

      Participant and setting

      A sample of 3363 people ≥60 years living in Stockholm were examined from March 2001 through August 2004.

      Measurements

      Chronic conditions were measured with: 1) multimorbidity (≥2 concurrent chronic diseases); 2) the Cumulative Illness Rating Scale, 3) polypharmacy (≥5 prescribed drugs), and 4) complex health problems (chronic diseases and/or symptoms along with cognitive and/or functional limitations).

      Results

      A total of 55.6% of 60–74 year olds and 13.4% of those ≥85 years did not have chronic conditions according to the four indicators. Multimorbidity and polypharmacy were the most prevalent indicators: 38% aged 60–74 and 76% aged ≥85 had multimorbidity; 24.3% aged 60–74 and 59% aged ≥85 had polypharmacy. Prevalence of chronic conditions as indicated by the comorbidity index and complex health problems ranged from 16.5% and 1.5% in the 60–74 year olds to 38% and 36% in the 85+ year olds, respectively. Prevalence of participants with 4 indicators was low, varying from 1.6% in those aged 60–74 to 14.9% in those aged ≥85 years. Older age was associated with higher odds of each of the 4 indicators; being a woman, with all indicators but multimorbidity; and lower educational level, only with complex health problems.

      Conclusions

      Prevalence of coexisting chronic conditions varies greatly by health indicator used. Variation increases when age, sex, and educational level are taken into account. These findings underscore the need of different indicators to capture health complexity in older adults.

      Keywords

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