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patterns of multimorbidity

Anna Luise Kirkengen
The highly demanding and, in a certain sense, unique, working conditions of general practitioners (GPs) are characterized by two phenomena: First, they involve an increasing familiarity with individual patients over time, which promotes a deepening of insight. Second, they enable the GP to encounter all kinds of health problems, which in turn facilitates pattern recognition, at both individual and group levels, particularly the kind of patterns currently termed "multimorbidity." Whereas the term "comorbidity" is used to denote states of bad health in which 1 disease is considered to predate and evoke other ailments or diseases, the term multimorbidity is applied when finding several presumably separate diseases in a person who suffers from them either sequentially or simultaneously...
May 31, 2018: Journal of Evaluation in Clinical Practice
Dawit T Zemedikun, Laura J Gray, Kamlesh Khunti, Melanie J Davies, Nafeesa N Dhalwani
OBJECTIVE: To assess the prevalence, disease clusters, and patterns of multimorbidity using a novel 2-stage approach in middle-aged and older adults from the United Kingdom. PATIENTS AND METHODS: Data on 36 chronic conditions from 502,643 participants aged 40 to 69 years with baseline measurements between March 13, 2006, and October 1, 2010, from the UK Biobank were extracted. We combined cluster analysis and association rule mining to assess patterns of multimorbidity overall and by age, sex, and ethnicity...
May 22, 2018: Mayo Clinic Proceedings
Karl Peltzer
BACKGROUND:  Little is known about the prevalence of non-communicable disease (NCD) multimorbidity among tuberculosis (TB) patients in Africa.Aim and setting: The aim of this study was to assess the prevalence of NCD multimorbidity, its pattern and impact on adverse health outcomes among patients with TB in public primary care in three selected districts of South Africa. METHODS:  In a cross-sectional survey, new TB and TB retreatment patients were interviewed, and medical records assessed in consecutive sampling within 1 month of anti-TB treatment...
April 11, 2018: African Journal of Primary Health Care & Family Medicine
Madison L Gates, Elizabeth G Hunter, Vivian Dicks, Peace N Jessa, Veronica Walker, Wonsuk Yoo
OBJECTIVES: Co-occurring chronic diseases are associated with functional limitations, particularly for the aging population ≥50 years old. Aging offenders (individual who are imprisoned) tend to have greater prevalence of chronic, mental health, and substance use disorders compared to non-imprisoned populations. Our primary aim was to determine patterns of co-occurring conditions associated with functional limitations among aging offenders. MATERIALS AND METHODS: We included all male offenders from one correctional system who were ≥50 years old (n = 2270) and extracted diagnoses for chronic diseases, mental health, substance use disorders, and functional limitations from an electronic health record...
April 2, 2018: Archives of Gerontology and Geriatrics
Jen-Hung Wang, Ya-Ju Wu, Boon Lead Tee, Raymond Y Lo
BACKGROUND: Little is known about the distribution of medical comorbidities in Alzheimer's disease (AD). OBJECTIVE: We aimed to describe the comorbidity pattern of AD in a nested case-control study. METHODS: Incident AD cases were identified by International Classification of Diseases codes in a random sample of 2 million individuals in Taiwan National Health Insurance program during 2001-2011. We further restricted cases to those treated with AD drugs of approved reimbursement...
2018: Journal of Alzheimer's Disease: JAD
Paul Gellert, Simon Eggert, Christine Zwillich, Stefan Hörter, Adelheid Kuhlmey, Dagmar Dräger
OBJECTIVES: A large proportion of the oldest old and centenarians live in long-term care facilities. Although there may be distinct care patterns in centenarians compared with other cohorts of oldest old, the exact development concerning prevalence, length of stay, and factors that are associated with long-term care status in the last years before death is unknown. DESIGN: Longitudinal analyses of health insurance data across 6 years before death. SETTING AND PARTICIPANTS: In all, 1398 institutionalized and noninstitutionalized oldest old [deceased at 80-89 (octogenarians), 90-99 (nonagenarians), or over 100 years of age (centenarians)] from Germany were included...
June 2018: Journal of the American Medical Directors Association
Scott J Dankel, Jeremy P Loenneke, Paul D Loprinzi
PURPOSE: The "fat-but-fit" paradigm has been evaluated. However, the duration of overweight/obesity within the "fat-but-fit" paradigm (ie, assessing body mass at more than 1 time point) has not been extensively evaluated, which was this study's purpose. DESIGN: Cross-sectional. SETTING: National Health and Nutrition Examination Survey 2003 to 2006. PARTICIPANTS: Ages 36 to 85; N = 3621. MEASURES: Physical activity assessed via accelerometry...
January 1, 2018: American Journal of Health Promotion: AJHP
Janko Janković, Sladjana Šiljak, Jelena Marinković, Bojan Kovač, Slavenka Janković
This study aimed to assess possible differences in health services utilization among people living with noncommunicable diseases (NCDs) in the Republic of Srpska (RS), Bosnia and Herzegovina, with special reference to NCD multimorbidity. In addition, the relationship between self-perceived health and health care utilization was assessed. Data were retrieved from the 2010 National Health Survey. A cross-sectional study design was used. A total of 4,673 persons aged 18 years and older were identified in the households, of which 4,128 were interviewed...
January 1, 2018: International Journal of Health Services: Planning, Administration, Evaluation
Ana Maria Rodrigues, Maria João Gregório, Rute Dinis Sousa, Sara S Dias, Maria José Santos, Jorge M Mendes, Pedro Simões Coelho, Jaime C Branco, Helena Canhão
INTRODUCTION: Portuguese adults have a long lifespan, but it is unclear whether they live a healthy life in their final years. We aimed to determine the prevalence of multimorbidity and characterize lifestyle and other health outcomes among older Portuguese adults. MATERIAL AND METHODS: We performed a cross-sectional evaluation of 2393 adults, aged 65 and older, during the second wave of follow-up of the EpiDoC cohort, a population-based study involving long-term follow-up of a representative sample of the Portuguese population...
February 28, 2018: Acta Médica Portuguesa
Jasper Tromp, Wan Ting Tay, Wouter Ouwerkerk, Tiew-Hwa Katherine Teng, Jonathan Yap, Michael R MacDonald, Kirsten Leineweber, John J V McMurray, Michael R Zile, Inder S Anand, Carolyn S P Lam
BACKGROUND: Comorbidities are common in patients with heart failure (HF) and complicate treatment and outcomes. We identified patterns of multimorbidity in Asian patients with HF and their association with patients' quality of life (QoL) and health outcomes. METHODS AND FINDINGS: We used data on 6,480 patients with chronic HF (1,204 with preserved ejection fraction) enrolled between 1 October 2012 and 6 October 2016 in the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry...
March 2018: PLoS Medicine
Albert Roso-Llorach, Concepción Violán, Quintí Foguet-Boreu, Teresa Rodriguez-Blanco, Mariona Pons-Vigués, Enriqueta Pujol-Ribera, Jose Maria Valderas
OBJECTIVE: The aim was to compare multimorbidity patterns identified with the two most commonly used methods: hierarchical cluster analysis (HCA) and exploratory factor analysis (EFA) in a large primary care database. Specific objectives were: (1) to determine whether choice of method affects the composition of these patterns and (2) to consider the potential application of each method in the clinical setting. DESIGN: Cross-sectional study. Diagnoses were based on the 263 corresponding blocks of the International Classification of Diseases version 10...
March 22, 2018: BMJ Open
J Bousquet, P Devillier, J M Anto, M Bewick, T Haahtela, S Arnavielhe, A Bedbrook, R Murray, M van Eerd, J A Fonseca, M Morais Almeida, A Todo Bom, E Menditto, G Passalacqua, C Stellato, M Triggiani, M T Ventura, G Vezzani, I Annesi-Maesano, R Bourret, I Bosse, D Caimmi, C Cartier, P Demoly, J Just, F Portejoie, V Siroux, F Viart, K C Bergmann, T Keil, L Klimek, R Mösges, O Pfaar, S Shamai, T Zuberbier, J Mullol, A Valero, O Spranger, P V Tomazic, M L Kowalski, P Kuna, M Kupczyk, F Raciborski, B Samolinski, S K Toppila-Salmi, E Valovirta, A A Cruz, F Sarquis-Serpa, J da Silva, R Stelmach, D Larenas-Linnemann, M Rodriguez Gonzalez, M T Burguete Cabañas, V Kvedariene, A Valiulis, N H Chavannes, W J Fokkens, D Ryan, A Sheikh, C Bachert, P W Hellings, O VandenPlas, N Ballardini, I Kull, E Melén, M Westman, M Wickman, C Bindslev-Jensen, E Eller, S Bosnic-Anticevich, R E O'Hehir, I Agache, T Bieber, T Casale, B Gemicioğlu, J C Ivancevich, G De Vries, M Sorensen, A Yorgancioglu, D Laune
BACKGROUND: Multimorbidity in allergic airway diseases is well known, but no data exist about the daily dynamics of symptoms and their impact on work. To better understand this, we aimed to assess the presence and control of daily allergic multimorbidity (asthma, conjunctivitis, rhinitis) and its impact on work productivity using a mobile technology, the Allergy Diary. METHODS: We undertook a 1-year prospective observational study in which 4 210 users and 32 585 days were monitored in 19 countries...
March 22, 2018: Allergy
Ronni Wolf, Branka Marinović
The world's population is now ageing at an unprecedented rate. Declining fertility and improved health and longevity have generated rising numbers and proportions of the older population in most parts of the world. With advancing age, however, comes an increasing incidence of disease (comorbidity or multimorbidity), an increasing use of medications (polypharmacy), and consequently an increase in adverse drug reactions (ADRs). Age-related changes in pharmacodynamics and pharmacokinetics (eg, volumes of drug distribution, metabolism and clearance, altered drug responsiveness and toxicity) and greater vulnerability to ADRs are other reasons for the higher incidence of ADRs in the elderly compared with young adults...
March 2018: Clinics in Dermatology
Grace Sum, Thomas Hone, Rifat Atun, Christopher Millett, Marc Suhrcke, Ajay Mahal, Gerald Choon-Huat Koh, John Tayu Lee
Background: Multimorbidity, the presence of two or more non-communicable diseases (NCD), is a costly and complex challenge for health systems globally. Patients with NCDs incur high levels of out-of-pocket expenditure (OOPE), often on medicines, but the literature on the association between OOPE on medicines and multimorbidity has not been examined systematically. Methods: A systematic review was conducted via searching medical and economics databases including Ovid Medline, EMBASE, EconLit, Cochrane Library and the WHO Global Health Library from year 2000 to 2016...
2018: BMJ Global Health
Anna Cassell, Duncan Edwards, Amelia Harshfield, Kirsty Rhodes, James Brimicombe, Rupert Payne, Simon Griffin
BACKGROUND: Multimorbidity places a substantial burden on patients and the healthcare system, but few contemporary epidemiological data are available. AIM: To describe the epidemiology of multimorbidity in adults in England, and quantify associations between multimorbidity and health service utilisation. DESIGN AND SETTING: Retrospective cohort study, undertaken in England. METHOD: The study used a random sample of 403 985 adult patients (aged ≥18 years), who were registered with a general practice on 1 January 2012 and included in the Clinical Practice Research Datalink...
April 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Davide L Vetrano, Debora Rizzuto, Amaia Calderón-Larrañaga, Graziano Onder, Anna-Karin Welmer, Roberto Bernabei, Alessandra Marengoni, Laura Fratiglioni
BACKGROUND: Functional decline is a strong health determinant in older adults, and chronic diseases play a major role in this age-related phenomenon. In this study, we explored possible clinical pathways underlying functional heterogeneity in older adults by quantifying the impact of cardiovascular (CV) and neuropsychiatric (NP) chronic diseases and their co-occurrence on trajectories of functional decline. METHODS AND FINDINGS: We studied 2,385 people ≥60 years (range 60-101 years) participating in the Swedish National study of Aging and Care in Kungsholmen (SNAC-K)...
March 2018: PLoS Medicine
Jenny Tran, Robyn Norton, Nathalie Conrad, Fatemeh Rahimian, Dexter Canoy, Milad Nazarzadeh, Kazem Rahimi
BACKGROUND: Multimorbidity in people with cardiovascular disease (CVD) is common, but large-scale contemporary reports of patterns and trends in patients with incident CVD are limited. We investigated the burden of comorbidities in patients with incident CVD, how it changed between 2000 and 2014, and how it varied by age, sex, and socioeconomic status (SES). METHODS AND FINDINGS: We used the UK Clinical Practice Research Datalink with linkage to Hospital Episode Statistics, a population-based dataset from 674 UK general practices covering approximately 7% of the current UK population...
March 2018: PLoS Medicine
Antoneta Granic, Nuno Mendonça, Tom R Hill, Carol Jagger, Emma J Stevenson, John C Mathers, Avan A Sayer
The population of older adults aged 85 years and over (the very old) is growing rapidly in many societies because of increases in life expectancy and reduced mortality at older ages. In 2016, 27.3 million very old adults were living in the European Union, and in the UK, 2.4% of the population (1.6 million) were aged 85 and over. Very old age is associated with increased risks of malnutrition, multimorbidity, and disability. Diet (nutrition) is a modifiable risk factor for multiple age-related conditions, including sarcopenia and functional decline...
February 27, 2018: Nutrients
Takuya Aoki, Yosuke Yamamoto, Tatsuyoshi Ikenoue, Yoshihiro Onishi, Shunichi Fukuhara
In the present study, we aimed to identify multimorbidity patterns in a Japanese population and investigate whether these patterns have differing effects on polypharmacy and dosage frequency. Data was collected on 17 chronic health conditions via nationwide cross-sectional survey of 3,256 adult Japanese residents. Factor analysis was performed to identify multimorbidity patterns, and associations were determined with excessive polypharmacy [concurrent use of ≥ 10 prescription or over-the-counter (OTC) medications] and higher dosage frequency ( ≥ 3 doses per day)...
February 28, 2018: Scientific Reports
C Hou, Z Ping, K Yang, S Chen, X Liu, H Li, M Liu, Y Ma, N Van Halm-Lutterodt, L Tao, Y Luo, X Yang, W Wang, X Li, X Guo
OBJECTIVES: In China, few studies reported the disability situation and the association between disabilities with chronic conditions in aged people. This study investigates the cross-sectional trends of prevalence and severity of activities of daily living disability (ADL) in Chinese oldest-old people from 1998 to 2008, and identified the potential risk factors of disability. DESIGN: A combination of population-based longitudinal prospective study and probabilistically sampling cross-sectional studies...
2018: Journal of Nutrition, Health & Aging
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