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- Harrison, C, et al.
(författare)
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Comorbidity versus multimorbidity: Why it matters
- 2021
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Ingår i: Journal of multimorbidity and comorbidity. - : SAGE Publications. - 2633-5565. ; 11, s. 2633556521993993-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Martínez-Velilla, N, et al.
(författare)
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Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults
- 2022
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Ingår i: Journal of multimorbidity and comorbidity. - : SAGE Publications. - 2633-5565. ; 12, s. 26335565221145461-
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Tidskriftsartikel (refereegranskat)abstract
- Different multimorbidity patterns present with different prognoses, but it is unknown to what extent they may influence the effectiveness of an individualized multicomponent exercise program offered to hospitalized older adults. Methods This study is a secondary analysis of a randomized controlled trial conducted in the Department of Geriatric Medicine of a tertiary hospital. In addition to the standard care, an exercise-training multicomponent program was delivered to the intervention group during the acute hospitalization period. Multimorbidity patterns were determined through fuzzy c-means cluster analysis, over 38 chronic diseases. Functional, cognitive and affective outcomes were considered. Results Three hundred and six patients were included in the analyses (154 control; 152 intervention), with a mean age of 87.2 years, and 58.5% being female. Four patterns of multimorbidity were identified: heart valves and prostate diseases (26.8%); metabolic diseases and colitis (20.6%); psychiatric, cardiovascular and autoimmune diseases (16%); and an unspecific pattern (36.6%). The Short Physical Performance Battery (SPPB) test improved across all patterns, but the intervention was most effective for patients in the metabolic/colitis pattern (2.48-point difference between intervention/control groups, 95% CI 1.60-3.35). Regarding the Barthel Index and the Mini Mental State Examination (MMSE), the differences were significant for all multimorbidity patterns, except for the psychiatric/cardio/autoimmune pattern. Differences concerning quality of life were especially high for the p sychiatric/cardio/autoimmune pattern (16.9-point difference between intervention/control groups, 95% CI 4.04, 29.7). Conclusions Patients in all the analyzed multimorbidity patterns improved with this tailored program, but the improvement was highest for those in the metabolic pattern. Understanding how different chronic disease combinations are associated with specific functional and cognitive responses to a multicomponent exercise intervention may allow further tailoring such interventions to older patients’ clinical profile.
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- Wilk, P, et al.
(författare)
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Multimorbidity in large Canadian urban centres: A multilevel analysis of pooled 2015-2018 cross-sectional cycles of the Canadian Community Health Survey
- 2021
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Ingår i: Journal of multimorbidity and comorbidity. - : SAGE Publications. - 2633-5565. ; 11, s. 26335565211058037-
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Tidskriftsartikel (refereegranskat)abstract
- There is limited knowledge on how the prevalence of multimorbidity varies within and across major Canadian urban centres. The objective of this study was to investigate the between-neighbourhood variation in the prevalence of multimorbidity in Canada’s large urban centres, controlling for compositional effects associated with individual-level demographic and socioeconomic factors. Methods Cross-sectional data from the 2015–2018 cycles of the Canadian Community Health Survey (CCHS) were pooled at the microdata level. Respondents (20 years and older) residing in one of the 35 census metropolitan areas (CMAs) were included ( N = 100,803). Census tracts (CTs) were used as a measure of neighbourhood. To assess the between-neighbourhood differences in multimorbidity prevalence, we fitted three sequential random intercept logistic regression models. Results During the 2015–2018 period, 8.1% of residents of large urban centres had multimorbidity. The results from the unadjusted model indicate that 13.4% of the total individual variance in multimorbidity could be attributed to the between-neighbourhood differences. After adjustment for overall characteristics of the CMAs in which these neighbourhoods are located, as well as for individual-level demographic and socioeconomic factors related to compositional effects, 11.0% of the individual variance in multimorbidity could still be attributed to the between-neighbourhood differences. Conclusion There is significant and substantial geographic variation in multimorbidity prevalence across neighbourhoods in Canada’s large urban centres. Residing in some neighbourhoods could be associated with increased odds of having multimorbidity, even after accounting for overall characteristics of the CMAs in which these neighbourhoods are located, as well as individual-level factors.
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