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Research ArticleResearch

Multimorbidity predicts functional decline in community-dwelling older adults

Prospective cohort study

Philip D. St John, Suzanne L. Tyas, Verena Menec, Robert Tate and Lauren Griffith
Canadian Family Physician February 2019, 65 (2) e56-e63;
Philip D. St John
Geriatrician in Winnipeg and Associate Professor at the University of Manitoba.
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  • For correspondence: pstjohn@hsc.mb.ca
Suzanne L. Tyas
Epidemiologist and Associate Professor at the University of Waterloo in Ontario.
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Verena Menec
Professor in the Department of Community Health Sciences at the University of Manitoba.
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Robert Tate
Professor in the Department of Community Health Sciences at the University of Manitoba.
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Lauren Griffith
Associate Professor in the Department of Clinical Epidemiology and Biostatistics at McMaster University in Hamilton, Ont.
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Abstract

Objective To determine if multimorbidity is associated with functional status, and to assess if multimorbidity predicts declining functional status over a 5-year time frame, after accounting for baseline functional status and other potential confounding factors.

Design Analysis of an existing population-based cohort study.

Setting Manitoba.

Participants Community-dwelling adults aged 65 and older.

Main outcome measures Age, sex, education, and the Mini-Mental State Examination (MMSE) and Center for Epidemiological Studies Depression Scale (CES-D) scores were recorded for each patient. Multimorbidity was measured using a simple tally of self-reported diseases. Function was measured using the Older Americans Resources and Services scale in 1991 to 1992 and again 5 years later. Good or excellent level of function was compared with level of disability (mild or moderate or higher). Cross-sectional and prospective analyses were conducted.

Results In a cross-sectional analysis, multimorbidity predicted disability. The unadjusted odds ratio (OR) (95% CI) for disability was 1.45 (1.39 to 1.52) for each additional chronic illness. In models adjusting for age, sex, education, and MMSE and CES-D scores, the adjusted OR (95% CI) was 1.35 (1.29 to 1.42) for each additional chronic illness. Multimorbidity also predicted disability 5 years later. The unadjusted OR (95% CI) was 1.31 (1.24 to 1.38). In models adjusting for age, sex, education, and MMSE and CES-D scores in addition to baseline functional status, the adjusted OR (95% CI) was 1.15 (1.09 to 1.24).

Conclusion Multimorbidity predicts disability in cross-sectional and prospective analyses.

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Canadian Family Physician: 65 (2)
Canadian Family Physician
Vol. 65, Issue 2
1 Feb 2019
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Multimorbidity predicts functional decline in community-dwelling older adults
Philip D. St John, Suzanne L. Tyas, Verena Menec, Robert Tate, Lauren Griffith
Canadian Family Physician Feb 2019, 65 (2) e56-e63;

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Multimorbidity predicts functional decline in community-dwelling older adults
Philip D. St John, Suzanne L. Tyas, Verena Menec, Robert Tate, Lauren Griffith
Canadian Family Physician Feb 2019, 65 (2) e56-e63;
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