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Burden and Patterns of Multi-morbidity: Impact on Disablement in Older Adults.

Abstract

OBJECTIVE

We aimed to assess the impact of the burden and patterns of multi-morbidity on disability domains.In a cross-sectional study of 425 older adults from the Boston Rehabilitative Impairment Study of the Elderly, participants self-reported 13 chronic conditions and underwent assessment of body function (leg strength, velocity, and power, trunk extensor endurance, leg range of motion, foot sensation), activities (400 m walk test, Short Physical Performance Battery, Late Life Function and Disability Instrument (LLFDI) function scores) and participation (LLFDI-participation scores). We tested the association between multi-morbidity patterns (identified by Latent Class Analysis, LCA) and disablement measures, as well as multi-morbidity burden (captured by a multi-morbidity score) and disablement measures.

RESULTS

LCA identified three classes - low multi-morbidity, high multi-morbidity and predominantly musculoskeletal conditions. Class membership (multi-morbidity pattern) was not associated with disablement measures, but multi-morbidity score was associated with poor performance in all domains. A 1-point higher multi-morbidity score was associated with lower scores in body functions (by 0.06 Standard Deviation (SD) unit), activities (0.07 - 0.10 SD units) as well as the participation (0.07 - 0.09 units).

CONCLUSION

Multi-morbidity counts may be an excellent tool for risk stratification and identification of persons in need of rehabilitation.

Authors+Show Affiliations

Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio.Boston University School of Public Health.New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System. Division of Aging, Brigham and Women's Hospital, Harvard Medical School.New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System. Department of Psychiatry, Harvard Medical School.College of Nursing and Health Sciences, University of Massachusetts Boston.Department of Physical Therapy, MGH Institute of Health Professions.New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System. Department of Physical Medicine and Rehabilitation, Harvard Medical School. Spaulding Rehabilitation Hospital.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31972615

Citation

Jacob, Mini E., et al. "Burden and Patterns of Multi-morbidity: Impact On Disablement in Older Adults." American Journal of Physical Medicine & Rehabilitation, 2020.
Jacob ME, Ni P, Driver J, et al. Burden and Patterns of Multi-morbidity: Impact on Disablement in Older Adults. Am J Phys Med Rehabil. 2020.
Jacob, M. E., Ni, P., Driver, J., Leritz, E., Leveille, S. G., Jette, A. M., & Bean, J. F. (2020). Burden and Patterns of Multi-morbidity: Impact on Disablement in Older Adults. American Journal of Physical Medicine & Rehabilitation, doi:10.1097/PHM.0000000000001388.
Jacob ME, et al. Burden and Patterns of Multi-morbidity: Impact On Disablement in Older Adults. Am J Phys Med Rehabil. 2020 Jan 16; PubMed PMID: 31972615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Burden and Patterns of Multi-morbidity: Impact on Disablement in Older Adults. AU - Jacob,Mini E, AU - Ni,Pengsheng, AU - Driver,Jane, AU - Leritz,Elizabeth, AU - Leveille,Suzanne G, AU - Jette,Alan M, AU - Bean,Jonathan F, Y1 - 2020/01/16/ PY - 2020/1/24/entrez PY - 2020/1/24/pubmed PY - 2020/1/24/medline JF - American journal of physical medicine & rehabilitation JO - Am J Phys Med Rehabil N2 - OBJECTIVE: We aimed to assess the impact of the burden and patterns of multi-morbidity on disability domains.In a cross-sectional study of 425 older adults from the Boston Rehabilitative Impairment Study of the Elderly, participants self-reported 13 chronic conditions and underwent assessment of body function (leg strength, velocity, and power, trunk extensor endurance, leg range of motion, foot sensation), activities (400 m walk test, Short Physical Performance Battery, Late Life Function and Disability Instrument (LLFDI) function scores) and participation (LLFDI-participation scores). We tested the association between multi-morbidity patterns (identified by Latent Class Analysis, LCA) and disablement measures, as well as multi-morbidity burden (captured by a multi-morbidity score) and disablement measures. RESULTS: LCA identified three classes - low multi-morbidity, high multi-morbidity and predominantly musculoskeletal conditions. Class membership (multi-morbidity pattern) was not associated with disablement measures, but multi-morbidity score was associated with poor performance in all domains. A 1-point higher multi-morbidity score was associated with lower scores in body functions (by 0.06 Standard Deviation (SD) unit), activities (0.07 - 0.10 SD units) as well as the participation (0.07 - 0.09 units). CONCLUSION: Multi-morbidity counts may be an excellent tool for risk stratification and identification of persons in need of rehabilitation. SN - 1537-7385 UR - https://www.unboundmedicine.com/medline/citation/31972615/Burden_and_Patterns_of_Multi-morbidity:_Impact_on_Disablement_in_Older_Adults L2 - http://dx.doi.org/10.1097/PHM.0000000000001388 DB - PRIME DP - Unbound Medicine ER -