Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty

© 2018 The Author(s). Background: Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditio...

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Main Authors: Ana Rivera-Almaraz, Betty Manrique-Espinoza, José Alberto Ávila-Funes, Somnath Chatterji, Nirmala Naidoo, Paul Kowal, Aarón Salinas-Rodríguez
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Published: 2018
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spelling th-cmuir.6653943832-627862018-11-29T07:50:14Z Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty Ana Rivera-Almaraz Betty Manrique-Espinoza José Alberto Ávila-Funes Somnath Chatterji Nirmala Naidoo Paul Kowal Aarón Salinas-Rodríguez Medicine © 2018 The Author(s). Background: Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions. Methods: Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument. All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models. Results: Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (β = 5.05; p < 0.01 and β = 5.10; p < 0.01, respectively) and decreased WHOQOL score (β = - 1.81; p < 0.01 and β = - 2.99; p < 0.01, respectively). Vascular-metabolic was associated with mortality (HR = 1.47; p = 0.04), disability (β = 3.27; p < 0.01) and quality of life (β = - 1.30; p = 0.02). Frailty was associated with mortality (pre-frail: HR = 1.48; p = 0.02 and frail: HR = 1.68; p = 0.03), disability (pre-frail: β = 5.02; p < 0.01; frail: β = 13.29; p < 0.01) and quality of life (pre-frail: β = - 2.23; p < 0.01; frail: β = - 4.38; p < 0.01). Interaction terms of frailty and multimorbidity were not statistically significant. Conclusions: Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided. 2018-11-29T07:50:14Z 2018-11-29T07:50:14Z 2018-10-04 Journal 14712318 2-s2.0-85054459990 10.1186/s12877-018-0928-7 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85054459990&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/62786
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Ana Rivera-Almaraz
Betty Manrique-Espinoza
José Alberto Ávila-Funes
Somnath Chatterji
Nirmala Naidoo
Paul Kowal
Aarón Salinas-Rodríguez
Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty
description © 2018 The Author(s). Background: Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions. Methods: Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument. All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models. Results: Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (β = 5.05; p < 0.01 and β = 5.10; p < 0.01, respectively) and decreased WHOQOL score (β = - 1.81; p < 0.01 and β = - 2.99; p < 0.01, respectively). Vascular-metabolic was associated with mortality (HR = 1.47; p = 0.04), disability (β = 3.27; p < 0.01) and quality of life (β = - 1.30; p = 0.02). Frailty was associated with mortality (pre-frail: HR = 1.48; p = 0.02 and frail: HR = 1.68; p = 0.03), disability (pre-frail: β = 5.02; p < 0.01; frail: β = 13.29; p < 0.01) and quality of life (pre-frail: β = - 2.23; p < 0.01; frail: β = - 4.38; p < 0.01). Interaction terms of frailty and multimorbidity were not statistically significant. Conclusions: Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided.
format Journal
author Ana Rivera-Almaraz
Betty Manrique-Espinoza
José Alberto Ávila-Funes
Somnath Chatterji
Nirmala Naidoo
Paul Kowal
Aarón Salinas-Rodríguez
author_facet Ana Rivera-Almaraz
Betty Manrique-Espinoza
José Alberto Ávila-Funes
Somnath Chatterji
Nirmala Naidoo
Paul Kowal
Aarón Salinas-Rodríguez
author_sort Ana Rivera-Almaraz
title Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty
title_short Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty
title_full Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty
title_fullStr Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty
title_full_unstemmed Disability, quality of life and all-cause mortality in older Mexican adults: Association with multimorbidity and frailty
title_sort disability, quality of life and all-cause mortality in older mexican adults: association with multimorbidity and frailty
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85054459990&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/62786
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