1,721,776 research outputs found
Prevalence of disability according to multimorbidity and disease clustering: a population-based study
Full text linkBackground: The prevalence of chronic diseases has increased with population ageing, and research has attempted to elucidate the correlation between chronic diseases and disability. However, most studies in older populations have focused on the effect of single disabling conditions, even though most older adults have more than one chronic disease (multimorbidity). Objective: The aims of this study were to evaluate the association of disability with disease, in terms of multimorbidity and specified pairs of diseases, in a population-based study of older adults. Materials and Methods: Using the Kungsholmen Project, we estimated the prevalence of disability by the number of chronic diseases, disease status by organ systems, and in specific pairs of chronic conditions, in a Swedish population (n=1,099; ≥77 years). Disability was defined as need of assistance in at least one activity of daily living (Katz index). Results: Functional disability was seen in 17.9% of participants. It increased as the number of chronic diseases increased. The prevalence of disability varied greatly amongst specific pairs of diseases: from 6.7% in persons affected by hypertension and atrial fibrillation to 82.4% in persons affected by dementia and hip fracture. In multivariate logistic regression models, the disease pairs that were significantly associated with the highest increased relative odds of disability contained dementia (dementia–hip fracture, dementia–CVD, and dementia–depression). Conclusions: Our findings suggest specific pairs of diseases are much more highly associated with disability than others, particularly diseases coupled with dementia. This knowledge may improve prevention of disablement and planning of resource distribution.Journal of Comorbidity 2011;1(1):11–1
Socioeconomic status during lifetime and cognitive impairment no-dementia in late life: the population-based Aging in the In-Chianti Area study.
No full textThe impact of chronic multimorbidity and disability on functioning and survival. A community-based, longitudinal study
No full textAbstract. Marengoni A, von Strauss E, Rizzuto D,
Winblad B, Fratiglioni L (Aging Research Center,
Gerontology Research Center and Karolinska Institutet,
Stockholm, Sweden, and University of Brescia
and Civili Hospital, Brescia, Italy). The impact of
chronic multimorbidity and disability on functional
decline and survival in elderly persons. A communitybased,
longitudinal study. J Intern Med 2009;
265: 288–295.
Objective. We aimed to disentangle the effect of
chronic multimorbidity and disability on 3-year functional
decline and survival in the elderly.
Design. Prospective cohort study with a mean of follow-
up of 2.8 years.
Setting. Swedish elderly persons from the Kungsholmen
Project (1987–2000).
Subjects. A total of 1099 subjects, 77–100 years old,
living in the community and institutions.
Main outcome measurements. Medical diagnoses (based
on clinical examination, drug use, medical records
and blood tests), and functional assessment (according
to Katz Index) at baseline were investigated in relation
to functional decline and death occurring during
follow-up.
Results. At baseline, 12.1% of participants had disability,
and 52.3% were affected by multimorbidity. During
follow-up, 363 persons died and 85 worsened in
functioning. The number of chronic conditions incrementally
increased the risk of functional decline [hazard
ratio (HR) increased from 1.5 in subjects with one
disease to 6.2 in persons with 4+ diseases]. However,
this was not the case for mortality, as the HR of death
was the same for people with one disease as well as 4+
diseases (HR = 2.3). Baseline disability had the highest
impact on survival, independently of number of diseases
[HR = 8.1; 95% confidence interval (CI) = 4.8–
13.7 in subjects with one disease and HR = 7.7; 95%
CI = 4.7–12.6 in those with 2+ diseases].
Conclusions. In the elderly subjects, chronic disability
rather than multimorbidity emerged as the strongest
negative prognostic factor for functionality and
survival
Five-year mortality in dementia: The role of co-existing diseases and dementia severity.
No full textThe epidemiology of the dementias: an update.
No full textPurpose of review
The epidemiology of dementia is one of the priority fields in
aging research. This review aims to highlight the most
relevant findings over last years concerning occurrence, risk
factors, and prevention of dementia and its major subtypes.
Recent findings
It is estimated that currently around 24 million people have
dementia in the world, with the number being projected to
double every 20 years, and that 60% of dementia patients
live in developing countries, with the proportion being
raised to more than 70% by 2040. Current evidence
suggests that vascular factors, such as midlife
hypertension, diabetes, and cerebrovascular disease,
contribute significantly to the development of dementia and
Alzheimer’s disease, and that active engagement in mental,
physical, and social activities may postpone the onset of
dementia by providing cognitive reserve.
Summary
Dementia represents a major public health challenge as
a consequence of rapid increase in the aging population
worldwide, especially in developing countries. This
challenge can be partly confronted by successful
development of preventive strategies. Evidence has
emerged that proper control of vascular disorders and
maintenance of active lifestyles may prevent or delay the
onset and progression of dementia and Alzheimer’s
disease. Intervention trials are warranted to determine, to
what extent, such programs are effective against dementia
Stato socioeconomico durante la vita e decadimento cognitivo non-demenza in età geriatrica. lo studio di popolazione InChianti
No full textClinical progression of dementia is worsened and accelerated by multimorbidity in a population-based study.
No full textHETEROGENEITY IN RISK FACTORS FOR COGNITIVE IMPAIRMENT, NO DEMENTIA: Population-Based Longitudinal Study From the Kungsholmen Project.
Full text linkOBJECTIVES:
The objectives of this study were to investigate the relation of vascular, neuropsychiatric, social, and frailty-related factors with "Cognitive impairment, no dementia" (CIND) and to verify their effect independently of future progression to Alzheimer disease (AD).
METHODS:
Seven hundred eighteen subjects aged 75+ years who attended baseline, 3- and 6-year follow-up examinations of the Kungsholmen Project, a Swedish prospective cohort study, were studied. CIND was defined according to the performance on the Mini-Mental State Examination. Potential risk factors were collected at baseline and clustered according to four research hypotheses (frailty, vascular, neuropsychiatric, and social hypothesis), each representing a possible pathophysiological mechanism of CIND independently of subsequent development of AD.
RESULTS:
Over a mean 3.4 years of follow up, 82 participants (11.4%) developed CIND. When the population was subsequently followed for a mean of 2.7 years, subjects with CIND had a threefold increased risk to progress to AD. After multiple adjustments, including adjustment for the development of AD at the 6-year follow up, risk factors for CIND were hip fracture, polypharmacy, and psychoses.
CONCLUSIONS:
The results suggest that not only the AD-type neurodegenerative process, but also neuropsychiatric- and frailty-related factors may induce cognitive impairment in nondemented elderly. These findings may have relevant preventive and therapeutic implications
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