title: Combined impact of geriatric syndromes and cardiometabolic diseases on measures of functional impairment.
abstract: BACKGROUND
  Examine the independent and joint effects of geriatric syndromes (GS) and cardiometabolic diseases (CMDs) on functional impairment.
  
  
  METHODS
  Cross-sectional analysis of baseline data from the Women's Health Initiative, including 62,829 women aged 65 years or older. GS (urinary incontinence, falls, and depression measured by the shortened Center for Epidemiological Studies-Depression scale/Diagnostic Interview Schedule screening instrument) and CMD (coronary artery disease, coronary heart failure, and diabetes) were self-reported. Physical and social functioning and general health subscales of the Short Form-36 dichotomized at the median for the study sample were used to assess functional impairment. Additive interaction between burden of GS and CMD was assessed using logistic regression models.
  
  
  RESULTS
  Forty-three percent of women had at least one GS; 14.1% had at least one CMD; and 6.9% had at least one of each. Compared with women with no GS or CMD, women with one or more GS but no CMD were as likely to have physical functioning impairments (odds ratio [OR] = 1.79; 95% confidence interval [CI] = 1.73, 1.86) as those with CMD alone (OR = 1.97; CI = 1.84, 2.10). The association with social functioning was stronger for GS alone (OR = 2.10; CI = 2.02, 2.18) compared with CMD (OR = 1.60; CI = 1.50, 1.71). The association with general health was stronger for CMD alone (OR = 2.15; CI = 2.01, 2.29) compared with GS (OR = 1.68; CI = 1.62, 1.74). Significant interactions between GS and CMD were observed for all functional measures with 20%-30% of observed ORs attributable to additive interaction.
  
  
  CONCLUSIONS
  GSs alone are associated with functional impairment in older women; the association is stronger in the presence of even one CMD.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, 1505 Race Street, Mail Stop 1033, Bellet 6th Floor, Philadelphia, PA 19102, USA. alr44@drexel.edu
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Rosso
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Robert
authors.initials: R
authors.lastname: Wallace
authors.forename: Rachel
authors.initials: R
authors.lastname: Gold
authors.forename: J David
authors.initials: JD
authors.lastname: Curb
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
authors.forename: Yvonne L
authors.initials: YL
authors.lastname: Michael
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000375:Aging; D002318:Cardiovascular Diseases / Q000150:complications*; D003072:Cognition Disorders; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008659:Metabolic Diseases / Q000150:complications*; D014549:Urinary Incontinence / Q000150:complications*