title: Coexisting chronic conditions in the older population: Variation by health indicators.
abstract: BACKGROUND
  This study analyzes the prevalence and patterns of coexisting chronic conditions in older adults.
  
  
  METHODS
  Cross-sectional.
  A sample of 3363 people ≥60years living in Stockholm were examined from March 2001 through August 2004.
  
  
  METHODS
  Chronic conditions were measured with: 1) multimorbidity (≥2 concurrent chronic diseases); 2) the Cumulative Illness Rating Scale, 3) polypharmacy (≥5 prescribed drugs), and 4) complex health problems (chronic diseases and/or symptoms along with cognitive and/or functional limitations).
  
  
  RESULTS
  A total of 55.6% of 60-74year olds and 13.4% of those ≥85years did not have chronic conditions according to the four indicators. Multimorbidity and polypharmacy were the most prevalent indicators: 38% aged 60-74 and 76% aged ≥85 had multimorbidity; 24.3% aged 60-74 and 59% aged ≥85 had polypharmacy. Prevalence of chronic conditions as indicated by the comorbidity index and complex health problems ranged from 16.5% and 1.5% in the 60-74year olds to 38% and 36% in the 85+ year olds, respectively. Prevalence of participants with 4 indicators was low, varying from 1.6% in those aged 60-74 to 14.9% in those aged ≥85years. Older age was associated with higher odds of each of the 4 indicators; being a woman, with all indicators but multimorbidity; and lower educational level, only with complex health problems.
  
  
  CONCLUSIONS
  Prevalence of coexisting chronic conditions varies greatly by health indicator used. Variation increases when age, sex, and educational level are taken into account. These findings underscore the need of different indicators to capture health complexity in older adults.
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Italy. Electronic address: Alessandra.marengoni@unibs.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Angleman
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Bettina
authors.initials: B
authors.lastname: Meinow
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Giola
authors.initials: G
authors.lastname: Santoni
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mangialasche
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Debora
authors.initials: D
authors.lastname: Rizzuto
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Fastbom
authors.affiliation: Department of Geriatric Medicine, Nijmegen Alzheimer Centre 925, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Renè
authors.initials: R
authors.lastname: Melis
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Marti
authors.initials: M
authors.lastname: Parker
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Johnell
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet, Sweden; Stockholm University, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
authors.forename: Laura
authors.initials: L
authors.lastname: Fratiglioni
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019338:Polypharmacy; D015995:Prevalence; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology
keywords: Complex health problems; Cumulative Illness Rating Scale; Health indicators; Multimorbidity; Polypharmacy