当前位置： SCI文献检索 > JOURNAL OF INTERNAL MEDICINE期刊下所有文献 > Multimorbidity and functional impairment-bidirectional interplay, synergistic effects and common pathways.

Multimorbidity and functional impairment-bidirectional interplay, synergistic effects and common pathways.

Abstract：

:This review discusses the interplay between multimorbidity (i.e. co-occurrence of more than one chronic health condition in an individual) and functional impairment (i.e. limitations in mobility, strength or cognition that may eventually hamper a person's ability to perform everyday tasks). On the one hand, diseases belonging to common patterns of multimorbidity may interact, curtailing compensatory mechanisms and resulting in physical and cognitive decline. On the other hand, physical and cognitive impairment impact the severity and burden of multimorbidity, contributing to the establishment of a vicious circle. The circle may be further exacerbated by people's reduced ability to cope with treatment and care burden and physicians' fragmented view of health problems, which cause suboptimal use of health services and reduced quality of life and survival. Thus, the synergistic effects of medical diagnoses and functional status in adults, particularly older adults, emerge as central to assessing their health and care needs. Furthermore, common pathways seem to underlie multimorbidity, functional impairment and their interplay. For example, older age, obesity, involuntary weight loss and sedentarism can accelerate damage accumulation in organs and physiological systems by fostering inflammatory status. Inappropriate use or overuse of specific medications and drug-drug and drug-disease interactions also contribute to the bidirectional association between multimorbidity and functional impairment. Additionally, psychosocial factors such as low socioeconomic status and the direct or indirect effects of negative life events, weak social networks and an external locus of control may underlie the complex interactions between multimorbidity, functional decline and negative outcomes. Identifying modifiable risk factors and pathways common to multimorbidity and functional impairment could aid in the design of interventions to delay, prevent or alleviate age-related health deterioration; this review provides an overview of knowledge gaps and future directions.

journal_name

J Intern Med

journal_title

Journal of internal medicine

authors

Calderón-Larrañaga A,Vetrano DL,Ferrucci L,Mercer SW,Marengoni A,Onder G,Eriksdotter M,Fratiglioni L

doi

10.1111/joim.12843

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

255-271

issue

eissn

0954-6820

issn

1365-2796

journal_volume

285

pub_type

杂志文章,评审

在线工具

Multimorbidity and functional impairment-bidirectional interplay, synergistic effects and common pathways.