title: The association of multimorbidity and disability in a community-based sample of elderly aged 80 or older in Shanghai, China.
abstract: Both multimorbidity and activities of daily living (ADL) disability and instrument activities of daily living (IADL) disability are common among elderly individuals. ADL/IADL disability may reduce individuals' capacities for independent living and quality of life. This study aimed to examine the association between multimorbidity and ADL/IADL disability.
  
  
  
  A multi-stage cluster sample of 2058 residents aged 80 or older was investigated in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases with ten common chronic conditions under consideration. Subjects who responded that they "need partial or full assistance" to any ADL/IADL items were defined as having ADL/IADL disability. We examined the association of multimorbidity with ADL/IADL disability, adjusted for socio-demographic characteristics by using logistic regression.
  
  
  
  Of respondents, 23.23 % had ADL disability, 37.90 % had IADL disability, and 49.17 % had multimorbidity. After adjusted socio-demographic characteristics, a graded association was showed between ADL disability and the quantity of chronic conditions: odds ratio (OR) for 1 condition, 1.53(95 % confidence interval [CI], 1.04-2.24); OR for 2 conditions, 2.06(95 % CI, 1.43-2.96); OR for 3 conditions, 3.23(95 % CI, 2.14-4.86); OR for 4 or more conditions, 5.61(95 % CI, 3.26-9.66). Similar associations were also observed between the quantity of chronic conditions and IADL disability.
  
  
  
  The quantity of chronic conditions had relatively strong association with both ADL and IADL disability. Initiating prevention of additional chronic conditions and interventions on clusters of diseases may decrease the potential risk of ADL/IADL disability. Additionally, more attention should been given to the older low-income women living with relatives/non-relatives with multimorbidity.
authors: Department of Medical Administration, Guangzhou General Hospital of P.L.A., Guangzhou, 510010, China.
authors: Peng
authors: P
authors: Su
authors: Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.|Shanghai Health Development Research Center, Shanghai, 200040, China.
authors: Hansheng
authors: H
authors: Ding
authors: Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
authors: Wei
authors: W
authors: Zhang
authors: Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
authors: Guangfeng
authors: G
authors: Duan
authors: School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, 200433, China.
authors: Yitong
authors: Y
authors: Yang
authors: Shanghai Population and Development Research Center, Shanghai, 201199, China.
authors: Rong
authors: R
authors: Chen
authors: Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
authors: Zengjie
authors: Z
authors: Duan
authors: Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.|Shanghai Health Development Research Center, Shanghai, 200040, China.
authors: Lixia
authors: L
authors: Du
authors: Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.|Shanghai Health Development Research Center, Shanghai, 200040, China.
authors: Chunyan
authors: C
authors: Xie
authors: Shanghai Medical Science & Technology Information Center, Shanghai, 200031, China.|Shanghai Health Development Research Center, Shanghai, 200040, China.|Shanghai Population and Development Research Center, Shanghai, 201199, China.
authors: Chunlin
authors: C
authors: Jin
authors: Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
authors: Chaoqun
authors: C
authors: Hu
authors: Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
authors: Zixue
authors: Z
authors: Sun
authors: Department of Health Services Management, the Second Military Medical University, Shanghai, 200433, China.
authors: Junrui
authors: J
authors: Long
authors: Community Health Service Center, Jiangning Street, Jing'an District, Shanghai, 200040, China.
authors: Lingling
authors: L
authors: Gong
authors: School of Social Development and Public Policy, Fudan University, No. 220 Handan Rd, Shanghai, 200433, China. wh_tian@aliyun.com.
authors: Wenhua
authors: W
authors: Tian
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000369:Aged, 80 and over; D000375:Aging; D002681:China / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D011788:Quality of Life
keywords: Chinese; Community-dwelling; Disability; Elderly; Multimorbidity