Burden and Patterns of Multimorbidity: Impact on Disablement in Older Adults.
Mini E Jacob, Pengsheng Ni, Jane Driver and 4 others
PMID 32301768WHAT IT FOUND
A higher count of chronic conditions was linked to worse strength, walking, activity and participation in older adults with mobility problems.
Specific disease patterns were not linked to these outcomes. The count may be more useful than the condition mix.
Key findings
01After adjustment for age, gender, race, BMI, physical activity, pain and cognition, a higher chronic condition count was associated with lower leg strength, leg power, trunk extensor endurance, SPPB score, gait speed, and activity and participation sub-scores.
02For each one-point higher count, the standardized associations were 0.06 SD for body functions and structure, 0.07 to 0.10 SD for activities, and 0.07 to 0.09 SD for participation.
03Latent class patterns of multi-morbidity were not significantly associated with disablement outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study measured everything at one time, so it cannot show whether more conditions caused worse function or whether worse function was linked to having more conditions. Chronic conditions were self-reported, and the study did not consider how long someone had them or how they were treated. All participants already had mobility problems and were from Boston-area primary care practices, so the results may not apply to older adults without mobility problems or to more diverse populations. The cognitive measure used, the Mini-Mental State Examination, may not detect subtle executive function differences that could affect participation. Some physical measures had missing data, though sensitivity analysis with imputed data did not change the results.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that having more chronic conditions causes disability. The study measured everything at one time, so it can only show association. Do not dismiss specific disease patterns either; they were not associated with disablement in this sample, but that does not prove they never matter.