Abstract:
OBJECTIVES:To explore how different frameworks and categories of chronic conditions impact multimorbidity (defined as two or more chronic conditions) prevalence estimates and associations with patient-important functional outcomes. DESIGN:Baseline data from a population-based cohort study. SETTING:National sample of Canadians. PARTICIPANTS:A total of 51 338 community-living adults, aged 45 to 85 years. MAIN OUTCOME MEASURES:Chronic conditions from three commonly recognized frameworks were categorized as: (1) diseases, (2) risk factors, or (3) symptoms. Estimates of multimorbidity prevalence were compared among frameworks by age and sex. Separate weighted logistic regression models were used to explore the impact of the different frameworks and categories of chronic conditions on odds ratios (ORs) for multimorbidity for four patient-important functional outcomes: disability, social participation restriction, and self-rated physical and mental health. RESULTS:One framework included diseases and risk factors, and two frameworks included diseases, risk factors, and symptoms. The prevalence of multimorbidity differed among the frameworks, ranging from 33.5% to 60.6% having two or more chronic conditions. Including risk factors in frameworks increased prevalence estimates, while including symptoms increased prevalence estimates and associations with most patient-important outcomes. The two frameworks that included symptoms had the largest ORs for associations with disability, social participation restriction, and self-rated physical health but not self-rated mental health. Similar results were found when we compared ORs for patient-important outcome for multimorbidity based on three subframeworks: one including diseases only, one including diseases and risk factors, and one including diseases, risk factors, and symptoms. CONCLUSIONS:Including risk factors appeared to increase only the prevalence of multimorbidity without significantly altering relationships to outcomes. The inclusion of symptoms increased prevalence and associations with patient-important outcomes. These findings underscore the importance of considering not only the number, but also the category, of conditions included in multimorbidity frameworks, as simply counting the number of diagnoses may reduce sensitivity to outcomes that are important to individuals. J Am Geriatr Soc 67:1632-1640, 2019.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Griffith LE,Gilsing A,Mangin D,Patterson C,van den Heuvel E,Sohel N,St John P,van den Akker M,Raina Pdoi
10.1111/jgs.15921subject
Has Abstractpub_date
2019-08-01 00:00:00pages
1632-1640issue
8eissn
0002-8614issn
1532-5415journal_volume
67pub_type
杂志文章abstract:OBJECTIVES:To analyze the costs for long-stay (>90 days) nursing home (NH) decedents with and without hospice care. DESIGN:Retrospective cohort study using a 1999-2009 data set of linked Medicare and Medicaid claims and minimum data set (MDS) assessments. SETTING:Indiana NHs. PARTICIPANTS:Long-stay NH decedents (N =...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14070
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To assess the association between kidney function and change in body composition in older individuals. DESIGN:Prospective cohort study. SETTING:Two sites, Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS:Three thousand twenty-six well-functioning, participants aged 70 to 79 in the Health, Ag...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2007.01398.x
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVES:To determine whether the characteristics of the usual medical care providers of older antidepressant users changed between 1986 and 1997 with the introduction of selective serotonin reuptake inhibitors. DESIGN:Longitudinal study. SETTING:Five-county Piedmont area of North Carolina. PARTICIPANTS:Stratified...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2006.00737.x
更新日期:2006-06-01 00:00:00
abstract::The relative importance of dementia, gender, age and functional status (FS) was examined for relationships to mortality within five years after admission of the subjects to a New York City nursing home for the aged. Using a random sample of 212 of the nursing home's patients, a statistical model was developed to estim...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb03354.x
更新日期:1981-11-01 00:00:00
abstract:OBJECTIVES:To map the extent, range, and nature of research on the effectiveness, level of use, and perceptions about electronic medication administration records (eMARs) in long-term care facilities (LTCFs) and identify gaps in current knowledge and priority areas for future research. DESIGN:Scoping review of quantit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.15384
更新日期:2018-07-01 00:00:00
abstract::Some studies have shown a negative association between age and serum albumin. Several of these studies included older people with known disease. Disease may reduce albumin in any age group. Other studies have shown no association between age and albumin. To investigate the association of age and albumin, albumin level...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb06917.x
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between selected chronic medical conditions (CMCs) and fall injury events at home among community-dwelling older persons. DESIGN:Population-based case-control study. SETTING:The general community. PARTICIPANTS:Persons aged 65 and older living at home, excluding those using a whe...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb01480.x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:To test the effects of a communication skills training intervention on older patients' discourse during a primary care interview. DESIGN:A quasi-experimental design involving two intervention conditions. SETTING:The Family Practice Center of a university-based clinic. PARTICIPANTS:Thirty-three patients av...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.4911244.x
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:To assess the satisfaction of surrogate decision-makers with the decision to place feeding tubes in elderly patients with impaired decision-making capacity. DESIGN:Inception cohort followed for 5 weeks. SETTING:Four hospitals in the greater Los Angeles area. PARTICIPANTS:Fifty-eight surrogate decision-make...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb04946.x
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy of a computer-based physical activity program (Embodied Conversational Agent-ECA) with that of a pedometer control condition in sedentary older adults. DESIGN:Single-blind block-randomized controlled trial stratified according to clinic site and health literacy status. SETTING:Three...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.12449
更新日期:2013-10-01 00:00:00
abstract::Patients aged 70 years and older who were admitted to a coronary care unit in 1976 with documented acute myocardial infarction were followed to April 30, 1982. At that time, of the 46 patients who had survived initial hospitalization, 28 had died, 16 were still living, and two were lost to follow up. The actuarial sur...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb03714.x
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVES:To identify the strategies used by older persons to cope with chronic noncancer pain, determine the perceived effectiveness of the strategies, and ascertain factors associated with their use. DESIGN:Cross-sectional telephone survey. SETTING:Primary care practice located at a Veterans Affairs Medical Center...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52263.x
更新日期:2004-06-01 00:00:00
abstract::At an active outpatient geriatric program the gerontological team observed that Alzheimer patients appear to have fewer physical ailments than other elderly patients. To test this hypothesis, we reviewed a sample of 348 clinic patients. One hundred forty-three had a normal mental status; 75 had Alzheimer's disease as ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb01804.x
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVES:Evidence suggests inflammation is associated with cognitive impairment, but previous epidemiological studies have reported conflicting results. DESIGN:Prospective population-based cohort. SETTING:Epidemiology of Hearing Loss Study participants. PARTICIPANTS:Individuals without cognitive impairment in 1998...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12994
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To develop and validate the Physical Performance and Mobility Examination (PPME), an observer-administered, performance-based instrument assessing 6 domains of physical functioning and mobility for hospitalized elderly. DESIGN:Development of a pass-fail and 3-level scoring system and training manuals for the...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06535.x
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:The specific goals of the study were to compare three health status measures among older adults for their correlations with similar scales and to examine whether extreme (positive) health states might lead to measurement problems. We also report on practical administration and response problems among older a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05569.x
更新日期:1995-09-01 00:00:00
abstract::The effect of isobaric oxygenation on psychogeriatric subjects, with mild cognitive impairment was assessed in a single-blind controlled pilot study. Three of the 7 subjects were treated with a mixture of 97% oxygen plus 3% carbon dioxide, and 4 treated with compressed air. The oxygen or air was administered during tw...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1975.tb00389.x
更新日期:1975-02-01 00:00:00
abstract::Accumulating evidence from preclinical and clinical studies supports the hypothesis that oxidative stress may be associated with the onset and progression of Alzheimer's Disease (AD). Antioxidant therapies are being promoted in the lay press to enhance mental functions and delay cognitive losses with aging. An increas...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1998.tb01544.x
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVES:To assess the efficacy of a leg exercise performed in supine position to prevent orthostatic hypotension (OH) in older adults. DESIGN:Case-control study. SETTING:Division of Physical Medicine and Rehabilitation, Salvatore Maugeri Foundation, Scientific Institute of Veruno, Veruno, Italy. PARTICIPANTS:Indi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12313
更新日期:2013-07-01 00:00:00
abstract::In the last decade, a new degenerative dementia, probably the second most common after Alzheimer's disease (AD), has been increasingly recognized under the consensus name of dementia with Lewy bodies (DLB). This article reviews current clinical, genetic, and pathological DLB data and indicates directions for future re...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1998.tb06016.x
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence of self reported sleep disturbances in older men and women and to describe their relationships with health status and cardiovascular disease (CVD). DESIGN:Cross-sectional study of sleep disturbance, CVD, general health, psychosocial factors, physical function, and use of psychotro...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb00970.x
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of falls and identify risk factors for falls among older Mexican-American women. DESIGN:A prospective cohort study with an average follow-up of 2.7 years. SETTING:A clinical center at the Palo Alto Veterans Affairs Medical Center, California. PARTICIPANTS:152 community-dwelling M...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:Patient Health Priorities Identification (PHPI) is a values-based process in which trained facilitators assist older adults with multiple chronic conditions identify their health priorities. The purpose of this study was to evaluate patients' perceptions of PHPI. DESIGN:Qualitative study using thematic anal...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15850
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:To develop and test the Function-Focused Care in Assisted Living (FFC-AL) intervention so as to alter the decline that older adults in AL experience. DESIGN:Cluster-randomized controlled trial using repeated measures to test the effect of FFC-AL. SETTING:Four AL facilities with at least 100 beds. PARTICIP...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.2011.03699.x
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To compare the risk of serious hypoglycemia associated with the use of individual sulfonylureas in older people. DESIGN:A retrospective cohort study. SETTING:The Tennessee Medicaid Program. PATIENTS:A total of 13,963 Medicaid enrollees, aged 65 years or older, who were prescribed one of six sulfonylureas f...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb03729.x
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To further validate an objective measure of physical illness burden, the Cumulative Illness Rating Scale (CIRS). DESIGN:Survey with correlation of CIRS ratings made from physician interviews and review of medical records with post-mortem ratings made independently at tissue autopsy. SUBJECTS:Victims of comp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb05945.x
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:To assess clinical outcomes and identify risk factors for mortality in older adults with Staphylococcus aureus bloodstream infection (SAB). DESIGN:Retrospective review. SETTING:University of Michigan Health System, Ann Arbor. PARTICIPANTS:All patients aged 80 and older with SAB between January 2004 and Ju...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02666.x
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used. DESIGN:Analysis of cross-sectional and longitudinal data from the 2011-12 National...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13393
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To characterize a comprehensive outline of the oral microflora related to pneumonia in older adults. DESIGN:Prospective and retrospective longitudinal study. SETTING:Community. PARTICIPANTS:Long-term hospitalized patients and people in nursing homes (343 subjects, aged > or =65). MEASUREMENTS:Subjects we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02867.x
更新日期:2010-06-01 00:00:00
abstract::As nursing homes become increasingly important sites for biomedical and behavioral research, researchers must address the ethical problems of increased vulnerability and the high prevalence of mental and physical disorders in the nursing home population. Obtaining valid informed consent is but one of the many difficul...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1993.tb07470.x
更新日期:1993-07-01 00:00:00