Key result
AF, CKD, and visual impairment triad linked to ~4-fold higher 3-year mortality in octogenarians.
Why the study?
Do specific multimorbidity patterns increase all-cause mortality in community-dwelling octogenarians?
Cohort (n=328)
Yes
Do specific multimorbidity patterns increase all-cause mortality in community-dwelling octogenarians?
Specific combinations of chronic conditions, such as AF, CKD, and visual impairment, have a synergistic effect on mortality in octogenarians, highlighting the need for targeted multimorbidity management.
Answers are grounded in this paper and cite their sources.
AF+CKD+visual impairment pattern was associated with higher octogenarian mortality; extends multimorbidity evidence to specific clusters but leaves open targeted trials.
BACKGROUND: The population is aging and multimorbidity is becoming a common problem in the elderly. OBJECTIVE: To explore the effect of multimorbidity patterns on mortality for all causes at 3- and 5-year follow-up periods. MATERIALS AND METHODS: A prospective community-based cohort (2009-2014) embedded within a randomized clinical trial was conducted in seven primary health care centers, including 328 subjects aged 85 years at baseline. Sociodemographic variables, sensory status, cardiovascular risk factors, comorbidity, and geriatric tests were analyzed. Multimorbidity patterns were defined as combinations of two or three of 16 specific chronic conditions in the same individual. RESULTS: Of the total sample, the median and interquartile range value of conditions was 4 (3-5). The individual morbidities significantly associated with death were chronic obstructive pulmonary disease (COPD; hazard ratio [HR]: 2.47; 95% confidence interval [CI]: 1.3; 4.7), atrial fibrillation (AF; HR: 2.41; 95% CI: 1.3; 4.3), and malignancy (HR: 1.9; 95% CI: 1.0; 3.6) at 3-year follow-up; whereas dementia (HR: 2.04; 95% CI: 1.3; 3.2), malignancy (HR: 1.84; 95% CI: 1.2; 2.8), and COPD (HR: 1.77; 95% CI: 1.1; 2.8) were the most associated with mortality at 5-year follow-up, after adjusting using Barthel functional index (BI). The two multimorbidity patterns most associated with death were AF, chronic kidney disease (CKD), and visual impairment (HR: 4.19; 95% CI: 2.2; 8.2) at 3-year follow-up as well as hypertension, CKD, and malignancy (HR: 3.24; 95% CI: 1.8; 5.8) at 5 years, after adjusting using BI. CONCLUSION: Multimorbidity as specific combinations of chronic conditions showed an effect on mortality, which would be higher than the risk attributable to individual morbidities. The most important predicting pattern for mortality was the combination of AF, CKD, and visual impairment after 3 years. These findings suggest that a new approach is required to target multimorbidity in octogenarians.
No takes yet. Share an insight, caveat, or question.
Ferrer et al. (2017) conducted a cohort in Multimorbidity in octogenarians (n=328). Multimorbidity patterns (combinations of chronic conditions) vs. Participants without the specific multimorbidity combination was evaluated on All-cause mortality at 3-year follow-up for the combination of AF, CKD, and visual impairment (HR 4.19, 95% CI 2.2-8.2). The multimorbidity pattern of atrial fibrillation, chronic kidney disease, and visual impairment increased the risk of all-cause mortality at 3 years by over four-fold in octogenarians.
Synapse has enriched 10 related papers. Consider them for comparative context: