title: Multimorbidity measures were poor predictors of adverse events in patients aged ≥80 years: a prospective cohort study.
abstract: OBJECTIVE
  To assess and compare the ability of two measures of multimorbidity and a simple disease count (DC) to predict health outcomes in a population of patients aged ≥80 years.
  
  
  METHODS
  A prospective, observational, and population-based cohort study including 567 individuals [3.0 years (standard deviation ± 0.25) follow-up].
  
  
  RESULTS
  Of the patients, 37.6% were reported with five or more diseases. Multimorbidity was measured by means of a modified Charlson comorbidity index [mCCI; median score, 5 (range, 4-15)], Cumulative Illness Rating Scale [CIRS; median score, 4 (range, 1-11)], and a simple DC of 22 selected chronic conditions [median score, 4 (range, 0-13)]. All measures were independently related to mortality [adjusted hazard ratio (HR) mCCI, 2.5 (confidence interval {CI}: 1.5, 4.1); CIRS, 2.1 (CI: 1.4, 3.2); DC, 2.1 (CI: 1.4, 3.2)] and hospitalization [adjusted HR DC, 2.3 (CI: 1.7, 3.1); mCCI, 2.1 (CI: 1.5, 3.0), CIRS, 1.9 (CI: 1.5, 2.6)] but not to functional decline. Areas under the curve for mortality and hospitalization were all below 0.70. Net reclassification improvements did not indicate that any one measure provided a significant benefit over the others.
  
  
  CONCLUSIONS
  In this population, the mCCI, CIRS, and unweighted DC predicted mortality and hospitalization but not functional decline. There is no clear advantage of using one measure over another.
authors.affiliation: Department of Family Medicine and Primary Health Care, Ghent University (UG), UZ Gent 3K3 De Pintelaan, 185 9000 Ghent, Belgium. Electronic address: Pauline.boeckxstaens@ugent.be.
authors.forename: Pauline
authors.initials: P
authors.lastname: Boeckxstaens
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium; Department of Public and Primary HealthCare, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 35 blok d, box 7001, B-3000, Leuven, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Vaes
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium; Department of Public and Primary HealthCare, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 35 blok d, box 7001, B-3000, Leuven, Belgium.
authors.forename: Gijs
authors.initials: G
authors.lastname: Van Pottelbergh
authors.affiliation: Department of Family Medicine and Primary Health Care, Ghent University (UG), UZ Gent 3K3 De Pintelaan, 185 9000 Ghent, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: De Sutter
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
authors.forename: Delphine
authors.initials: D
authors.lastname: Legrand
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Adriaensen
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
authors.forename: Catharina
authors.initials: C
authors.lastname: Matheï
authors.affiliation: Pharmacy Department, Cliniques Universitaires Saint-Luc; Louvain Drug Research Institute (LDRI), Université Catholique de Louvain, Avenue E. Mounier 73, B-1200, Brussels, Belgium.
authors.forename: Olivia
authors.initials: O
authors.lastname: Dalleur
authors.affiliation: Institut de Recherche Santé et Societé, Université Catholique de Louvain (UCL), à Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium; Department of Public and Primary HealthCare, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 35 blok d, box 7001, B-3000, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Degryse
mesh_terms: D000369:Aged, 80 and over; D002908:Chronic Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D005853:Geriatrics; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate
keywords: Functional decline; Hospitalization; Measurement; Mortality; Multimorbidity; Older persons