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. 2022 May 12:8:23337214221098901.
doi: 10.1177/23337214221098901. eCollection 2022 Jan-Dec.

Disparity and Multimorbidity in Heart Failure Patients Over the Age of 80

Affiliations

Disparity and Multimorbidity in Heart Failure Patients Over the Age of 80

Anna Blach et al. Gerontol Geriatr Med. .

Abstract

Background: Healthcare is currently struggling to provide access and coverage for an increasingly diverse aging population who frequently have multiple co-morbid conditions complicating their care and medical management. Methods: This retrospective study analyzed the prevalence and distribution of common co-morbid conditions (hypertension, dyslipidemia, dementia, and diabetes mellitus) in 316 elderly heart failure patients (age range 80-103; mean 87 ±4.9). Results: Chart review analysis showed a racial distribution of 65 African American versus 251 Caucasian patients (21 vs. 79%). Hypertension was comparable in both groups (98.5% African American vs. 92.4% Caucasian). Dyslipidemia, diabetes and dementia diagnoses were all approximately 20% higher in African American versus Caucasian patients. The concurrent presence of all four conditions was approximately three times more prevalent in African Americans (18.5%) versus Caucasians (7.2%). Conclusion: Our study is unique for studying disparity in octogenarian and nonagenarians residing in a rural setting. Our results also highlight the importance of making a special effort to engage older African American patients in seeking healthcare. In addition, strategies must be designed to reduce barriers that impede access and availability of resources and clinical care, especially in economically underserved regions of the country.

Keywords: aging; cardiovascular diseases and risk; comorbidity; healthcare disparity; race/ethnicity.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Each comorbid condition complicating heart failure. While African Americans only made up 21% of the study cohort, they had a higher prevalence of each comorbid condition studied than their Caucasian counterpart. (HF = Heart Failure, HTN = Hypertension, DLD = Dyslipidemia, DM = Diabetes, Dem = Dementia).
Figure 2.
Figure 2.
Comorbid conditions complicating heart failure categorized into number of diagnoses, 1-5. Race appeared to factor into increased numbers of multimorbidity; where Caucasians were more likely to have 1, 2, or 3 concurrent diagnoses, African Americans were more likely to have 4 or 5 concurrent conditions affecting their heart failure.
Figure 3.
Figure 3.
Multimorbidity distribution; all patients had a diagnosis of heart failure in addition to other diagnoses. a: Cohort percentages of each condition; b: Patients with two concurrent conditions in addition to heart failure; c: Patients with three concurrent conditions in addition to heart failure. (HF = Heart Failure, HTN = Hypertension, DLD = Dyslipidemia, DM = Diabetes, Dem = Dementia).

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