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. 2018 Jun 25;18(1):147.
doi: 10.1186/s12877-018-0840-1.

Geriatric syndromes, multimorbidity, and disability overlap and increase healthcare use among older Chinese

Johnny T K Cheung  1 , Ruby Yu  2   3 , Zimu Wu  3 , Samuel Y S Wong  4 , Jean Woo  2   3
Affiliations

Geriatric syndromes, multimorbidity, and disability overlap and increase healthcare use among older Chinese

Johnny T K Cheung et al. BMC Geriatr. .

Abstract

Background: Geriatric syndromes, multimorbidity, and disability are prevalent among ageing population. However, no study empirically examined their additive or synergistic effect on healthcare use. The present study aims to estimate overlapping prevalence of geriatric syndromes, multimorbidity, and disability; and to examine associations of these three conditions with healthcare use.

Methods: A cross-sectional study was conducted in community-dwelling older adults aged 60 and above in 12 Hong Kong districts. Pearson's chi-squared test for trend was performed to examine prevalence of geriatric syndromes, multimorbidity, and disability across three age groups (60-69, 70-79, and ≥ 80). Multiple logistic regression was conducted to explore associations of these three conditions with three types of healthcare use (hospital admission, general outpatient clinic and specialist outpatient clinic attendance) respectively.

Results: Among 2618 participants, 75.3, 41.8, and 22.5% had geriatric syndromes, multimorbidity, and disability respectively, and 10.4% had all the three conditions. Prevalence of the three conditions and their coexistence significantly increased with age (p for trend < .001). Each condition was independently associated with at least two out of three types of healthcare use. Interestingly, the associations of multimorbidity and disability with specialist outpatient clinic attendance were weakened at older age, while the associations of geriatric syndromes with hospital admission and specialist outpatient clinic attendance were strengthened. Furthermore, the odds of all the three types of healthcare use increased with the number of conditions present (p for trend < .001).

Conclusions: Our findings support that the three conditions overlap and increase healthcare use. Early identification, prevention and intervention targeting older adults living with multiple healthcare needs are necessary.

Keywords: Disability; Geriatric; Health service use; Hospital admission; Multimorbidity; Outpatient; Overlap.

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Conflict of interest statement

Ethics approval and consent to participate

The study was performed in accordance with the Declaration of Helsinki. Ethics approval was granted by the Survey and Behavioural Research Ethics Committee of the Chinese University of Hong Kong. Written consent was obtained before the start of the survey.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Venn diagram displaying prevalence of geriatric syndromes, multimorbidity, and disability. Cramer’s V: .081 (p < .001) for multimorbidity-disability pair; .026 (p = .178) for multimorbidity-geriatric syndromes pair; .219 (p < .001) for geriatric syndromes-disability pair
Fig. 2
Fig. 2
Prevalence of geriatric syndromes, multimorbidity, disability, and coexistence of conditions by age groups. All trends in prevalence across age group were significant at p < .001. Coexistence of conditions refers to presence of two or more conditions (geriatric syndromes, multimorbidity, and disability) within same participant
Fig. 3
Fig. 3
Multiple logistic regression of healthcare use on geriatric syndromes, multimorbidity, and disability. a Hospital admission; b General Outpatient Clinic (GOPC) attendance; c specialist outpatient clinic (SOPC) attendance. Analyses were further adjusted for age, gender, marital status, education, and living arrangement. Reference groups were participants without any conditions
Fig. 4
Fig. 4
Multiple logistic regression of healthcare use on number and combination of conditions. a Hospital admission; b General Outpatient Clinic (GOPC) attendance; c specialist outpatient clinic (SOPC) attendance. Analyses were further adjusted for age, gender, marital status, education, and living arrangement. Reference groups were participants without any conditions. All trends in healthcare use over increasing number of conditions were significant at p < .001
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