scholarly journals Onset of Multiple Chronic Conditions and Depressive Symptoms: A Life Events Perspective

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Maureen Wilson-Genderson ◽  
Allison R Heid ◽  
Rachel Pruchno
Keyword(s):  
Heart Disease ◽  
Depressive Symptoms ◽  
Pulmonary Disease ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Psychological Impact ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
The Subject ◽  
Independent Effects

Abstract Background While the association between depressive symptoms and chronic illness has been the subject of many studies, little is known about whether depressive symptoms differ as a function of the illnesses people have as they transition to living with multiple chronic conditions. Methods Self-reports of five diagnosed chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) and depressive symptoms were provided by 3,396 people participating in three waves of the ORANJ BOWLSM research panel. Longitudinal multilevel modeling was used to examine the effects that transitioning to having a diagnosis of multiple chronic conditions has on depressive symptoms. Results Between 2006 and 2014, controlling for age, gender, income, race, and a lifetime diagnosis of depression, people who transitioned to having a diagnosis of multiple chronic conditions had significantly higher levels of depressive symptoms than people who did not make this transition. The diagnosis of arthritis, diabetes, heart disease, and pulmonary disease, but not hypertension had independent effects, increasing depressive symptoms. Conclusions Having a diagnosis of multiple chronic conditions leads to increases in depressive symptoms, but not all illnesses have the same effect. Findings highlight the need for clinicians to be aware of mental health risks in patients diagnosed with multiple chronic conditions, particularly those with a diagnosis of arthritis, diabetes, heart disease, and pulmonary disease. Clinical care providers should take account of these findings, encouraging psychosocial supports for older adults who develop multiple chronic conditions to minimize the negative psychological impact of illness diagnosis.

Spatial Associations of Multiple Chronic Conditions Among Older Adults

2016 ◽  
Vol 37 (11) ◽  
pp. 1411-1435 ◽  
Author(s):  
Ellen K. Cromley ◽  
Maureen Wilson-Genderson ◽  
Allison R. Heid ◽  
Rachel A. Pruchno
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Pulmonary Disease ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Local Concentration ◽  
Care Needs ◽  
Spatial Associations ◽  
Geographical Patterns ◽  
Effective Interventions

Multimorbidity, the presence of two or more chronic conditions in an individual, presents a major challenge for meeting the health care needs of older adults. This study advances understanding of multiple chronic conditions by using local colocation quotients to reveal spatial associations for five chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) in a statewide panel of older adults in New Jersey. Among adults with three or more conditions, large concentrations of Arthritis-Heart Disease-Pulmonary Disease, Arthritis-Hypertension-Pulmonary Disease, and Diabetes-Heart Disease-Hypertension were observed, each triad located in different regions of the state. Individuals with other triads of conditions, in contrast, were distributed among all older adults in the sample as expected with no areas of local concentration. The study provides gerontologists with a new and effective method for uncovering geographical patterns in combinations of chronic conditions among the populations they serve, thereby enabling more effective interventions.

scholarly journals A Systematic Review of Loneliness and Common Chronic Physical Conditions in Adults

2015 ◽  
Vol 8 (1) ◽  
pp. 113-132 ◽  
Author(s):  
Trisha Petitte ◽  
Jennifer Mallow ◽  
Emily Barnes ◽  
Ashley Petrone ◽  
Taura Barr ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Lung Disease ◽  
Chronic Conditions ◽  
Metabolic Disorders ◽  
Clinical Care ◽  
Multiple Chronic Conditions ◽  
Physical Conditions ◽  
Quantitative Studies ◽  
Prisma Statement

Loneliness is a prevalent and global problem for adult populations and has been linked to multiple chronic conditions in quantitative studies. This paper presents a systematic review of quantitative studies that examined the links between loneliness and common chronic conditions including: heart disease, hypertension, stroke, lung disease, and metabolic disorders. A comprehensive literature search process guided by the PRISMA statement led to the inclusion of 33 articles that measure loneliness in chronic illness populations. Loneliness is a significant biopsychosocial stressor that is prevalent in adults with heart disease, hypertension, stroke, and lung disease. The relationships among loneliness, obesity, and metabolic disorders are understudied but current research indicates that loneliness is associated with obesity and with psychological stress in obese persons. Limited interventions have demonstrated long-term effectiveness for reducing loneliness in adults with these same chronic conditions. Future longitudinal randomized trials that enhance knowledge of how diminishing loneliness can lead to improved health outcomes in persons with common chronic conditions would continue to build evidence to support the translation of findings to recommendations for clinical care.

scholarly journals Innovative Strategies to Facilitate Patient-Centered Research in Multiple Chronic Conditions

2021 ◽  
Vol 10 (10) ◽  
pp. 2112
Author(s):  
Tullika Garg ◽  
Courtney A. Polenick ◽  
Nancy Schoenborn ◽  
Jane Jih ◽  
Alexandra Hajduk ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Intervention Development ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Older Americans ◽  
Innovative Strategies ◽  
Department Of Health ◽  
Innovative Methods

Multiple chronic conditions (MCC) are one of today’s most pressing healthcare concerns, affecting 25% of all Americans and 75% of older Americans. Clinical care for individuals with MCC is often complex, condition-centric, and poorly coordinated across multiple specialties and healthcare services. There is an urgent need for innovative patient-centered research and intervention development to address the unique needs of the growing population of individuals with MCC. In this commentary, we describe innovative methods and strategies to conduct patient-centered MCC research guided by the goals and objectives in the Department of Health and Human Services MCC Strategic Framework. We describe methods to (1) increase the external validity of trials for individuals with MCC; (2) study MCC epidemiology; (3) engage clinicians, communities, and patients into MCC research; and (4) address health equity to eliminate disparities.

scholarly journals IMPACT OF MULTIPLE CHRONIC CONDITIONS ON CHANGE IN PHYSICAL FUNCTION FROM MID- TO EARLY LATE LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S540-S540
Author(s):  
Brittney S Lange Maia ◽  
Kelly Karavolos ◽  
Elsa Strotmeyer ◽  
Carrie Karvonen-Gutierrez ◽  
Elizabeth Avery ◽  
...  
Keyword(s):  
Heart Disease ◽  
Physical Function ◽  
Chronic Conditions ◽  
Additional Condition ◽  
Late Life ◽  
Multiple Chronic Conditions ◽  
Poisson Models ◽  
Sf 36 ◽  
Health Factors ◽  
Early Late

Abstract Chronic conditions emerging in midlife may be modifiable to prevent progression ultimately preserve physical function (PF) in late life. We quantified change in perceived PF in relation to several common chronic conditions known to impact PF in late life (osteoarthritis, diabetes, stroke, hypertension, heart disease, cancer, osteoporosis, and depression). Physical function (PF) was assessed using the Physical Functioning Scale of the SF-36 among 2,283 women in SWAN from an average age of 50.0±2.7 to 64.0±3.7 years. In covariate-adjusted Poisson models, each additional condition was associated with 3% worse PF (p<0.001), and an additional 0.4% annual worsening (p<0.001). Thus, holding demographic, lifestyle, socioeconomic, and other health factors constant, a woman a decade later entering old age with no chronic conditions would have 8.1%, 15.5%, and 17.0% better PF vs. having one, two, or three conditions, respectively. Preventing or delaying chronic disease progression in midlife may improve PF trajectories into late life.

scholarly journals Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability

2019 ◽  
Vol 54 (7) ◽  
pp. 455-469
Author(s):  
Courtney A Polenick ◽  
Kira S Birditt ◽  
Angela Turkelson ◽  
Helen C Kales
Keyword(s):  
Depressive Symptoms ◽  
Chronic Conditions ◽  
Functional Disability ◽  
Well Being ◽  
Multiple Chronic Conditions ◽  
Individual Level ◽  
Growth Curve Models ◽  
Rate Of Increase ◽  
The Individual ◽  
Retirement Study

Abstract Background Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability. Purpose We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability. Methods The U.S. sample included 3,991 couples drawn from nine waves (1998–2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner’s baseline depressive symptoms, and each partner’s number of chronic conditions across waves. Results Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels. Conclusions Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.

scholarly journals Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States

2017 ◽  
Vol 35 (18) ◽  
pp. 2053-2061 ◽  
Author(s):  
Gery P. Guy ◽  
K. Robin Yabroff ◽  
Donatus U. Ekwueme ◽  
Sun Hee Rim ◽  
Rui Li ◽  
...  
Keyword(s):  
Heart Disease ◽  
Economic Burden ◽  
Chronic Conditions ◽  
The United States ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Multiple Chronic Conditions ◽  
Lost Productivity ◽  
History Of ◽  
History Of Cancer

Purpose The prevalence of cancer survivorship and chronic health conditions is increasing. Limited information exists on the economic burden of chronic conditions among survivors of cancer. This study examines the prevalence and economic effect of chronic conditions among survivors of cancer. Methods Using the 2008 to 2013 Medical Expenditure Panel Survey, we present nationally representative estimates of the prevalence of chronic conditions (heart disease, high blood pressure, stroke, emphysema, high cholesterol, diabetes, arthritis, and asthma) and multiple chronic conditions (MCCs) and the incremental annual health care use, medical expenditures, and lost productivity for survivors of cancer attributed to individual chronic conditions and MCCs. Incremental use, expenditures, and lost productivity were evaluated with multivariable regression. Results Survivors of cancer were more likely to have chronic conditions and MCCs compared with adults without a history of cancer. The presence of chronic conditions among survivors of cancer was associated with substantially higher annual medical expenditures, especially for heart disease ($4,595; 95% CI, $3,262 to $5,927) and stroke ($3,843; 95% CI, $1,983 to $5,704). The presence of four or more chronic conditions was associated with increased annual expenditures of $10,280 (95% CI, $7,435 to $13,125) per survivor of cancer. Annual lost productivity was higher among survivors of cancer with other chronic conditions, especially stroke ($4,325; 95% CI, $2,687 to $5,964), and arthritis ($3,534; 95% CI, $2,475 to $4,593). Having four or more chronic conditions was associated with increased annual lost productivity of $9,099 (95% CI, $7,224 to $10,973) per survivor of cancer. The economic impact of chronic conditions was similar among survivors of cancer and individuals without a history of cancer. Conclusion These results highlight the importance of ensuring access to lifelong personalized screening, surveillance, and chronic disease management to help manage chronic conditions, reduce disruptions in employment, and reduce medical expenditures among survivors of cancer.

scholarly journals MANAGING MULTIPLE CHRONIC CONDITIONS: EXPERIENCES OF OLDER ADULTS, CAREGIVERS, AND CARE PROVIDERS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 73-73
Author(s):  
J. Ploeg ◽  
N. Matthew-Maich ◽  
K. Fraser ◽  
S. Dufour ◽  
C.A. McAiney ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Care Providers

scholarly journals Transition Experiences of Caregivers of Older Adults With Dementia and Multiple Chronic Conditions: An Interpretive Description Study

2020 ◽  
Vol 6 ◽  
pp. 237796082093429
Author(s):  
Annie Lam ◽  
Jenny Ploeg ◽  
Sandra L. Carroll ◽  
Wendy Duggleby ◽  
Carrie McAiney ◽  
...  
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Social Life ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Interpretive Description ◽  
Care Providers ◽  
Transition Experiences

Introduction Family caregivers provide most of the care for older persons living with dementia (PLWD) and multiple chronic conditions (MCCs) in the community. Caregivers experience transitions, such as changes to their health, roles, and responsibilities, during the process of caring. Transitions encompass a time when caregivers undergo stressful responses to change. However, we know little about the transition experiences of caregivers of persons living with both dementia and MCCs. Objective This qualitative study explored the transition experiences of caregivers of PLWD within the context of MCCs, from the perspective of both caregivers and practitioners. The research question was the following: What are the transition experiences of family caregivers in providing care to older PLWD and MCCs living in the community? Methods This study was conducted using an interpretive description approach. Semistructured interviews were conducted with 19 caregivers of older community-dwelling PLWD and MCCs and 7 health-care providers working with caregivers in Ontario, Canada. Concurrent data collection and inductive data analysis were used. Results Caregivers of older PLWD and MCCs experienced four key transitions: (a) taking on responsibility for managing multiple complex conditions, (b) my health is getting worse, (c) caregiving now defines my social life, and (d) expecting that things will change. Findings highlight how the coexistence of MCCs with dementia complicates caregiver transitions and the importance of social networks for facilitating transitions. Conclusion The study provided insight on the transition experiences of caregivers of older PLWD and MCCs. MCCs increased the care load and further complicated caregivers’ transition experiences. Health-care providers, such as nurses, can play important roles in supporting caregivers during these transitions and engage them as partners in care.

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