Chronic conditions, disability, and quality of life in older adults with multimorbidity in Spain.
BACKGROUND
As the population ages, the prevalence of multimorbidity also increases, with consequences to several health outcomes such as disability and quality of life (QoL). This study aimed at analyzing the relationships between chronic conditions, disability, and QoL of older adults with multimorbidity in Spain.


METHODS
Data on older adults aged 65 years or more, with at least two chronic health conditions were drawn from three cohort studies. Sample size was 705, 443, and 4995, respectively. For each cohort, the impact of the following chronic health conditions was analyzed: asthma, cancer, cardiac, diabetes, hypertension, mental health disorders, osteoarticular conditions, and stroke. Disability and QoL measures varied according to the survey.


RESULTS
In older adults with multimorbidity, the most prevalent conditions were osteoarticular (59.08-67.80%) and hypertension (50.64-60.03%). The presence of disability was significantly associated to having osteoarticular (OR range: 1.53 to 2.646), diabetes (OR: 1.86 to 1.71), or mental health disorders (OR: 2.19 to 3.36) in most cohorts. Disability (OR: 1.67 to 7.67), osteoarticular conditions (OR: 3.37 to 5.10), and mental health disorders (OR: 1.83 to 4.27) showed the highest effects on lower QoL than the population.


CONCLUSIONS
The presence of disability and diverse chronic conditions has a negative effect on QoL of older adults affected by multimorbidity in Spain. Public health and primary care interventions focusing on the integrated care of older adults with multimorbidity might give special attention to mental health and osteoarticular conditions.
National School of Public Health, Carlos III Institute of Health, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain. Electronic address: jforjaz@isciii.es.
Maria João
MJ
Forjaz
National Centre of Epidemiology, Carlos III Institute of Health and CIBERNED, Madrid, Spain.
Carmen
C
Rodriguez-Blazquez
National School of Public Health, Carlos III Institute of Health, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
Alba
A
Ayala
Institute of Economics, Geography and Demography, Spanish National Research Council, Madrid, Spain.
Vicente
V
Rodriguez-Rodriguez
National Centre of Epidemiology, Carlos III Institute of Health and CIBERNED, Madrid, Spain.
Jesús
J
de Pedro-Cuesta
Research Unit, Hospital Galdakao-Usansolo [Osakidetza] - Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.
Susana
S
Garcia-Gutierrez
IIS Aragon, Aragon Health Sciences Institute-Miguel Servet University Hospital, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Zaragoza, Spain.
Alexandra
A
Prados-Torres
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001847:Bone Diseases / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007592:Joint Diseases / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology; D011320:Primary Health Care; D011788:Quality of Life; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology
Aged; Cohort studies; Disability evaluation; Morbidity; Quality of life