title: Nondisease-specific problems and all-cause mortality in the REasons for Geographic and Racial Differences in Stroke study.
abstract: OBJECTIVE
  To evaluate the association between six nondisease-specific problems (problems that cross multiple domains of health) and mortality in middle-aged and older adults.
  
  
  METHODS
  Prospective, observational cohort.
  
  
  METHODS
  U.S. population sample.
  
  
  METHODS
  Participants included 23,669 black and white U.S. adults aged 45 and older enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.
  
  
  METHODS
  Nondisease-specific problems included cognitive impairment, depressive symptoms, exhaustion, falls, impaired mobility, and polypharmacy. Age-stratified (<65, 65-74, ≥ 75) hazard ratios for all-cause mortality were calculated for each problem individually and according to number of problems.
  
  
  RESULTS
  One or more nondisease-specific problems occurred in 40% of participants younger than 65, 45% of those aged 65 to 74, and 55% of those aged 75 and older. Compared with participants with none of these problems, the multivariable adjusted hazard ratio for all-cause mortality associated with each additional nondisease-specific problem was 1.34 (95% confidence interval (CI) = 1.23-1.46) for participants younger than 65, 1.24 (95% CI = 1.15-1.35) for those aged 65 to 74, and 1.30 (95% CI = 1.21-1.39) for those aged 75 and older.
  
  
  CONCLUSIONS
  Nondisease-specific problems were associated with mortality across a wide age spectrum. Future studies should explore whether treating these problems will improve survival and identify innovative healthcare models to address multiple nondisease-specific problems simultaneously.
authors.affiliation: Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA. bbowling@uab.edu
authors.forename: C Barrett
authors.initials: CB
authors.lastname: Bowling
authors.forename: John N
authors.initials: JN
authors.lastname: Booth
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.forename: Heather E
authors.initials: HE
authors.lastname: Whitson
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
authors.forename: Virginia G
authors.initials: VG
authors.lastname: Wadley
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.forename: Richard M
authors.initials: RM
authors.lastname: Allman
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D001741:Black or African American; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death / Q000639:trends; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011618:Psychotic Disorders / Q000150:complications / Q000209:etiology* / Q000401:mortality; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000150:complications / Q000208:ethnology* / Q000401:mortality; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D044465:White People