title: Multimorbidity in older women: the negative impact of specific combinations of chronic conditions on self-rated health.
abstract: BACKGROUND
  Chronic diseases are considered major threats to self-rated health (SRH). In many elderly people multimorbidity is present, in elderly women more than in elderly men. This study aims at establishing the impact of multimorbidity and specific disease combinations on SRH in elderly women.
  
  
  OBJECTIVE
  To study the relationship between the number of chronic diseases and SRH and explore possible effects of combinations of chronic conditions on SRH in elderly women.
  
  
  METHODS
  Health interview data used for this study originated from the second Dutch National Survey of General Practice, a study with a response rate of 64.5%. From the 12 699 respondents, 315 were females between 70 and 74 years old.
  
  
  RESULTS
  Of the women, 87% reported one or more chronic condition. Women without any chronic condition rated their health significantly better than those with one or more chronic conditions. Either severe back pain or severe headache was included in return the most prevalent combinations of two chronic conditions with a significantly higher negative impact on SRH than expected.
  
  
  CONCLUSIONS
  All combinations including severe headache and some combinations including severe back pain and another chronic condition had a significantly more negative impact on SRH than expected in women aged 70-74 years. General practitioners should be alert on severe headache and severe back pain in elderly women to improve proactive the quality of care and thus add to the quality of later years of life.
authors: Gender and Women's Health, Radboud University Nijmegen Medical Centre, Department of Primary and Community Care, 6500 HB Nijmegen, The Netherlands. hmmvos@hotmail.com
authors: Hedwig M M
authors: HM
authors: Vos
authors: Hans H
authors: HH
authors: Bor
authors: Marjolein J A van
authors: MJ
authors: Rangelrooij-Minkels
authors: François G
authors: FG
authors: Schellevis
authors: Antoine L M
authors: AL
authors: Lagro-Janssen
mesh_terms: D000368:Aged; D001416:Back Pain / Q000453:epidemiology*; D002908:Chronic Disease; D059350:Chronic Pain / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D020773:Headache Disorders / Q000453:epidemiology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012720:Severity of Illness Index