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

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.

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

Innovation in Aging ◽

10.1093/geroni/igx022 ◽

2017 ◽

Vol 1 (2) ◽

Cited By ~ 7

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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2016.71.9716 ◽

2017 ◽

Vol 35 (18) ◽

pp. 2053-2061 ◽

Cited By ~ 35

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.

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Spatial Associations of Multiple Chronic Conditions Among Older Adults

Journal of Applied Gerontology ◽

10.1177/0733464816672044 ◽

2016 ◽

Vol 37 (11) ◽

pp. 1411-1435 ◽

Cited By ~ 2

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.

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

The Open Psychology Journal ◽

10.2174/1874350101508010113 ◽

2015 ◽

Vol 8 (1) ◽

pp. 113-132 ◽

Cited By ~ 64

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.

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Impact of Chronic Medical Condition Development on Longitudinal Physical Function from Mid- to Early Late-Life: The Study of Women’s Health Across the Nation

The Journals of Gerontology Series A ◽

10.1093/gerona/glz243 ◽

2019 ◽

Vol 75 (7) ◽

pp. 1411-1417 ◽

Cited By ~ 1

Author(s):

Brittney S Lange-Maia ◽

Carrie A Karvonen-Gutierrez ◽

Rasa Kazlauskaite ◽

Elsa S Strotmeyer ◽

Kelly Karavolos ◽

...

Keyword(s):

Physical Function ◽

Women’S Health ◽

Women's Health ◽

Repeated Measures ◽

Short Form ◽

Late Life ◽

Chronic Medical Condition ◽

Early Late ◽

Annual Decline

Abstract Background Chronic medical conditions (CMCs) often emerge and accumulate during the transition from mid- to late-life, and the resulting multimorbidity can greatly impact physical function. We assessed the association of CMC presence and incidence on trajectories of physical function from mid- to early late-life in the Study of Women’s Health Across the Nation. Methods Physical function was assessed at eight clinic visits (average 14 years follow-up) using the physical function subscale of the Short Form-36. CMCs included osteoarthritis, diabetes, stroke, hypertension, heart disease, cancer, osteoporosis, and depressive symptomatology, and were considered cumulatively. Repeated-measures Poisson models estimated longitudinal change (expressed as percent difference) in physical function by chronic CMCs. Change-points assessed physical function change coincident with the development of a new condition. Results Women (N = 2,283) followed from age 50.0 ± 2.7 to 64.0 ± 3.7 years; 7.3% had zero CMCs through follow-up, 22.5% (N = 513) had no baseline CMCs but developed ≥1, 22.7% women had ≥1 baseline CMC but never developed another, and 47.6% had ≥1 baseline CMC and developed ≥1 more. Each additional baseline CMC was associated with 4.0% worse baseline physical function and annual decline of 0.20%/year. Women with more baseline CMCs had greater decline in physical function with a new CMC (−1.90% per condition); and annual decline when developing a new condition accelerated by −0.33%/year per condition. Conclusions Self-reported physical function changes are evident from mid- to early late-life with the development of CMCs. Preventing or delaying CMCs may delay declines in physical function, and these potential pathways to disability warrant further research.

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