Impact of Multimorbidity on Disability and Quality of Life in the Spanish Older Population

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends.

Methods

Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females.

Results

All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [β for 4+ diseases: −18.10 (−20.95,−15.25)] and greater disability [β for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability.

Conclusions

Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with gender idiosyncrasy in certain cases.

Related collections

Most cited references 56

Record: found
Abstract: found
Article: not found

The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties.

M Power, B Murphy, W Kuyken … (1998)

This paper reports on the field testing, empirical derivation and psychometric properties of the World Health Organisation Quality of Life assessment (the WHOQOL). The steps are presented from the development of the initial pilot version of the instrument to the field trial version, the so-called WHOQOL-100. The instrument has been developed collaboratively in a number of centres in diverse cultural settings over several years; data are presented on the performance of the instrument in 15 different settings worldwide.

0 comments Cited 429 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Progressive resistance strength training for improving physical function in older adults.

Chiung-ju Liu, Nancy Latham (2009)

Muscle weakness in old age is associated with physical function decline. Progressive resistance strength training (PRT) exercises are designed to increase strength. To assess the effects of PRT on older people and identify adverse events. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialized Register (to March 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 2), MEDLINE (1966 to May 01, 2008), EMBASE (1980 to February 06 2007), CINAHL (1982 to July 01 2007) and two other electronic databases. We also searched reference lists of articles, reviewed conference abstracts and contacted authors. Randomised controlled trials reporting physical outcomes of PRT for older people were included. Two review authors independently selected trials, assessed trial quality and extracted data. Data were pooled where appropriate. One hundred and twenty one trials with 6700 participants were included. In most trials, PRT was performed two to three times per week and at a high intensity. PRT resulted in a small but significant improvement in physical ability (33 trials, 2172 participants; SMD 0.14, 95% CI 0.05 to 0.22). Functional limitation measures also showed improvements: e.g. there was a modest improvement in gait speed (24 trials, 1179 participants, MD 0.08 m/s, 95% CI 0.04 to 0.12); and a moderate to large effect for getting out of a chair (11 trials, 384 participants, SMD -0.94, 95% CI -1.49 to -0.38). PRT had a large positive effect on muscle strength (73 trials, 3059 participants, SMD 0.84, 95% CI 0.67 to 1.00). Participants with osteoarthritis reported a reduction in pain following PRT(6 trials, 503 participants, SMD -0.30, 95% CI -0.48 to -0.13). There was no evidence from 10 other trials (587 participants) that PRT had an effect on bodily pain. Adverse events were poorly recorded but adverse events related to musculoskeletal complaints, such as joint pain and muscle soreness, were reported in many of the studies that prospectively defined and monitored these events. Serious adverse events were rare, and no serious events were reported to be directly related to the exercise programme. This review provides evidence that PRT is an effective intervention for improving physical functioning in older people, including improving strength and the performance of some simple and complex activities. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.

0 comments Cited 250 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy.

D. M. W. Kriegsman, B. Penninx, J T van Eijk … (1996)

The object of the study is to investigate the (in)accuracy of patients' self-reports, as compared with general practitioners' information, regarding the presence of specific chronic diseases, and the influence of patient characteristics. Questionnaire data of 2380 community-dwelling elderly patients, aged 55-85 years, on the presence of chronic non-specific lung disease, cardiac disease, peripheral atherosclerosis, stroke, diabetes, malignancies, and osteoarthritis/rheumatoid arthritis were compared with data from the general practitioners, using the kappa-statistic. Associations between the accuracy of self-reports and patient characteristics were studied by multiple logistic regression analyses. Kappa's ranged from 0.30 to 0.40 for osteoarthritis/rheumatoid arthritis and atherosclerosis, to 0.85 for diabetes mellitus. In the multivariate analyses, educational level, level of urbanization, deviations in cognitive function, and depressive symptomatology had no influence on the level of accuracy. An influence of gender, age, mobility limitations, and recent contact with the general practitioner was shown for specific diseases. For chronic non-specific lung disease, both "underreporting" and "overreporting" are more prevalent in males, compared to females. Furthermore, males tend to overreport stroke and underreport malignancies and arthritis, whereas females tend to overreport malignancies and arthritis. Both overreporting and underreporting of cardiac disease are more prevalent as people are older. Also, older age is associated with overreporting of stroke, and with underreporting of arthritis. The self-reported presence of mobility limitations is associated with overreporting of all specific diseases studied, except for diabetes mellitus, and its absence is associated with underreporting, except for diabetes mellitus and atherosclerosis. Recent contact with the general practitioner is associated with overreporting of cardiac disease, atherosclerosis, malignancies and arthritis, and with less frequent underreporting of diabetes and arthritis. Results suggest that patients' self-reports on selected chronic diseases are fairly accurate, with the exceptions of atherosclerosis and arthritis. The associations found with certain patient characteristics may be explained by the tendency of patients to label symptoms, denial by the patient, or inaccuracy of medical records.

0 comments Cited 170 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

M. Maria Glymour: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2014

Publication date (Electronic): 6 November 2014

Volume: 9

Issue: 11

Electronic Location Identifier: e111498

Affiliations

[1 ]Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain

[2 ]Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain

[3 ]Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain

[4 ]Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain

[5 ]Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain

[6 ]Department of Psychiatry, Universidad de Zaragoza and Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain

[7 ]Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain

San Francisco, United States of America

Author notes

* E-mail: jmharo@ 123456pssjd.org

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: JMH JLA MM BO. Performed the experiments: NG JMH JLA MM MVM BO. Analyzed the data: NG MVM BO MM JMH. Contributed reagents/materials/analysis tools: NG BO MVM JMH. Wrote the paper: NG AL BO JMH MM JLA. Critically revised the paper and approved the final version to be published: NG BO MVM AL JMH MM JLA.

Article

Publisher ID: PONE-D-14-18679

DOI: 10.1371/journal.pone.0111498

PMC ID: 4222819

PubMed ID: 25375890

SO-VID: 4012e71c-cc69-494b-8496-415cf5ccd8ec

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 29 April 2014

Date accepted : 30 September 2014

Page count

Pages: 12

Funding

The research leading to these results has received funding from the European Community's Seventh Framework Program (FP7/2007–2013) under grant agreement number 223071 (COURAGE in Europe) and the Spanish Ministry of Education, Culture and Sport (FPU12/05661). Additional support was provided by funds from the Instituto de Salud Carlos III-FIS research grant numbers PS09/00295 and PS09/01845, from the Spanish Ministry of Science and Innovation's ACIPromociona (ACI2009-1010). The study was supported by the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III. This article is part of a PhD program developed in the Public Health Department of the Universitat de Barcelona, Spain. B.O. is grateful to the Sara Borrell postdoctoral program (reference CD12/00429) supported by the Instituto de Salud Carlos III, Spain. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Custom metadata

Data Availability The authors confirm that all data underlying the findings are fully available without restriction. The COURAGE project is a collaborative effort between several European institutions and the World Health Organization. The questionnaire is based on the WHO's SAGE study, in order to allow future comparisons across countries. SAGE data is already available on the WHO's webpage. Researchers can contact them and SAGE team provides the data requested, as in other WHO's public databases. Data from the COURAGE will be available soon with a similar system. Until then, all the relevant data related to this paper will be available without restriction from the COURAGE study team in Spain ( beatriz.olaya@ 123456pssjd.org ) for consultation. This database covers the definition of “minimal dataset” by Plos One, to reach the conclusions drawn in the manuscript and to replicate the reported study findings in their entirety.

Impact of Multimorbidity on Disability and Quality of Life in the Spanish Older Population

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

PLOS Climate

Most cited references 56

The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties.

Progressive resistance strength training for improving physical function in older adults.

Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy.

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 384

Cited by 67

Most referenced authors 1,294