The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China

doi:10.1186/s12877-016-0352-9

. 2016 Oct 27;16(1):178.

doi: 10.1186/s12877-016-0352-9.

The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China

Peng Su¹, Hansheng Ding^{2

3}, Wei Zhang⁴, Guangfeng Duan⁴, Yitong Yang⁵, Rong Chen⁶, Zengjie Duan⁴, Lixia Du^{2

3}, Chunyan Xie^{2

3}, Chunlin Jin^{2

3

6}, Chaoqun Hu⁴, Zixue Sun⁴, Junrui Long⁴, Lingling Gong⁷, Wenhua Tian⁸

Affiliations

¹ Department of Medical Administration, Guangzhou General Hospital of P.L.A., Guangzhou, 510010, China.
² Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.
³ Shanghai Health Development Research Center, Shanghai, 200040, China.
⁴ Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
⁵ School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, 200433, China.
⁶ Shanghai Population and Development Research Center, Shanghai, 201199, China.
⁷ Community Health Service Center, Jiangning Street, Jing'an District, Shanghai, 200040, China.
⁸ School of Social Development and Public Policy, Fudan University, No. 220 Handan Rd, Shanghai, 200433, China. wh_tian@aliyun.com.

PMID: 27784269
PMCID: PMC5081877
DOI: 10.1186/s12877-016-0352-9

The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China

Peng Su et al. BMC Geriatr. 2016.

. 2016 Oct 27;16(1):178.

doi: 10.1186/s12877-016-0352-9.

Authors

Affiliations

¹ Department of Medical Administration, Guangzhou General Hospital of P.L.A., Guangzhou, 510010, China.
² Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.
³ Shanghai Health Development Research Center, Shanghai, 200040, China.
⁴ Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
⁵ School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, 200433, China.
⁶ Shanghai Population and Development Research Center, Shanghai, 201199, China.
⁷ Community Health Service Center, Jiangning Street, Jing'an District, Shanghai, 200040, China.
⁸ School of Social Development and Public Policy, Fudan University, No. 220 Handan Rd, Shanghai, 200433, China. wh_tian@aliyun.com.

PMID: 27784269
PMCID: PMC5081877
DOI: 10.1186/s12877-016-0352-9

Abstract

Background: Both multimorbidity and activities of daily living (ADL) disability and instrument activities of daily living (IADL) disability are common among elderly individuals. ADL/IADL disability may reduce individuals' capacities for independent living and quality of life. This study aimed to examine the association between multimorbidity and ADL/IADL disability.

Methods: A multi-stage cluster sample of 2058 residents aged 80 or older was investigated in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases with ten common chronic conditions under consideration. Subjects who responded that they "need partial or full assistance" to any ADL/IADL items were defined as having ADL/IADL disability. We examined the association of multimorbidity with ADL/IADL disability, adjusted for socio-demographic characteristics by using logistic regression.

Results: Of respondents, 23.23 % had ADL disability, 37.90 % had IADL disability, and 49.17 % had multimorbidity. After adjusted socio-demographic characteristics, a graded association was showed between ADL disability and the quantity of chronic conditions: odds ratio (OR) for 1 condition, 1.53(95 % confidence interval [CI], 1.04-2.24); OR for 2 conditions, 2.06(95 % CI, 1.43-2.96); OR for 3 conditions, 3.23(95 % CI, 2.14-4.86); OR for 4 or more conditions, 5.61(95 % CI, 3.26-9.66). Similar associations were also observed between the quantity of chronic conditions and IADL disability.

Conclusions: The quantity of chronic conditions had relatively strong association with both ADL and IADL disability. Initiating prevention of additional chronic conditions and interventions on clusters of diseases may decrease the potential risk of ADL/IADL disability. Additionally, more attention should been given to the older low-income women living with relatives/non-relatives with multimorbidity.

Keywords: Chinese; Community-dwelling; Disability; Elderly; Multimorbidity.

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References

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[1] Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: the Women’s Health and Aging Study. J Clin Epidemiol. 1999;52(1):27–37. doi: 10.1016/S0895-4356(98)00124-3. - DOI - PubMed

[2] Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: the Women’s Health and Aging Study. J Clin Epidemiol. 1999;52(1):27–37. doi: 10.1016/S0895-4356(98)00124-3. - DOI - PubMed

[3] United Nations . Department of Economic and Social Affairs, Population Division (2013). World Population Ageing 2013. ST/ESA/SER.A/348. New York: United Nations; 2013.

[4] United Nations . Department of Economic and Social Affairs, Population Division (2013). World Population Ageing 2013. ST/ESA/SER.A/348. New York: United Nations; 2013.

[5] Ebrahim S, Pearce N, Smeeth L, Casas JP, Jaffar S, Piot P. Tackling non-communicable diseases in low- and middle-income countries: is the evidence from high-income countries all we need? PLoS Med. 2013;10(1):e1001377. doi: 10.1371/journal.pmed.1001377. - DOI - PMC - PubMed

[6] Ebrahim S, Pearce N, Smeeth L, Casas JP, Jaffar S, Piot P. Tackling non-communicable diseases in low- and middle-income countries: is the evidence from high-income countries all we need? PLoS Med. 2013;10(1):e1001377. doi: 10.1371/journal.pmed.1001377. - DOI - PMC - PubMed

[7] Miranda JJ, Kinra S, Casas JP, Davey Smith G, Ebrahim S. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Tropical Med Int Health. 2008;13(10):1225–1234. doi: 10.1111/j.1365-3156.2008.02116.x. - DOI - PMC - PubMed

[8] Miranda JJ, Kinra S, Casas JP, Davey Smith G, Ebrahim S. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Tropical Med Int Health. 2008;13(10):1225–1234. doi: 10.1111/j.1365-3156.2008.02116.x. - DOI - PMC - PubMed

[9] Barberger-Gateau P, Rainville C, Letenneur L, Dartigues JF. A hierarchical model of domains of disablement in the elderly: a longitudinal approach. Disabil Rehabil. 2000;22(7):308–317. doi: 10.1080/096382800296665. - DOI - PubMed

[10] Barberger-Gateau P, Rainville C, Letenneur L, Dartigues JF. A hierarchical model of domains of disablement in the elderly: a longitudinal approach. Disabil Rehabil. 2000;22(7):308–317. doi: 10.1080/096382800296665. - DOI - PubMed

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The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China

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The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China

Authors

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Abstract

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