title: The Impact of Multimorbidity and Coronary Disease Comorbidity on Physical Function in Women Aged 80 Years and Older: The Women's Health Initiative.
abstract: BACKGROUND
  A better understanding of medically centered outcomes, such as physical function, for older women with multiple chronic conditions is a national public health priority.
  
  
  METHODS
  The prevalence of multimorbidity (defined as having 2 chronic conditions from a list of 12) and comorbidity with coronary disease (CHD) were calculated for 33,386 women who were enrolled in the Women's Health Initiative since 1993-1998 and were ≥ 80 years old by mid-September 2012. Associations between multimorbidity and CHD comorbidity on RAND-36 physical function scores were estimated using linear regression models.
  
  
  RESULTS
  The prevalence of multimorbidity in this sample was 59%. Women with 0-1 chronic condition had a mean physical function score of 74 (95% confidence interval [CI]: 73, 74). Relative decrements in physical function scores were -8 (95% CI: -8, -7), -13 (95% CI: -14, -12) and -19 (95% CI: -20, -18) in women with 2, 3, and ≥ 4 chronic conditions, respectively. Women with CHD in combination with hip fractures or cognitive impairment had the largest adjusted decreases in physical function scores compared to the scores for women with CHD only. The impact of select characteristics on physical function scores between multimorbid and non-multimorbid women were similar; however, overall mean physical functions scores were lower for women with multmorbidity.
  
  
  CONCLUSIONS
  Multimorbidity profoundly impacted physical functioning in women aged more than 80 years. Modifiable risk factors, such as obesity and physical activity, were similar in older women regardless of multimorbidity status and provide targets for health interventions aimed at preventing loss of late-age physical functioning.
authors: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. erillama@whi.org.
authors: Eileen
authors: E
authors: Rillamas-Sun
authors: Department of Family and Preventive Medicine, University of California San Diego, La Jolla.
authors: Andrea Z
authors: AZ
authors: LaCroix
authors: Department of Geriatric Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu.
authors: Christina L
authors: CL
authors: Bell
authors: Department of Epidemiology, University of Iowa College of Public Health.
authors: Kelli
authors: K
authors: Ryckman
authors: Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester.
authors: Judith K
authors: JK
authors: Ockene
authors: Department of Epidemiology, University of Iowa College of Public Health.
authors: Robert B
authors: RB
authors: Wallace
mesh_terms: D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015897:Comorbidity; D003327:Coronary Disease / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D016387:Women's Health
keywords: Cardiovascular; Multimorbidities; Physical function