title: Effect of Multimorbidity on Health-Related Quality of Life in Adults Aged 55 Years or Older: Results from the SU.VI.MAX 2 Cohort.
abstract: BACKGROUND
  Multimorbid chronic diseases are usually considered separately in trials. Here, we aimed to describe overall multimorbidity patterns in adults aged 55 years or older and assess their effect on health-related quality of life (HRQoL).
  
  
  METHODS
  We used data for 5,647 participants included in the SUpplémentation en VItamines et Minéraux AntioXydants 2 (SU.VI.MAX 2) population-based trial. HRQoL was assessed by the French versions of the Medical Outcome Study Short Form 36 and the Duke Health Profile. An exploratory factor analysis was used to determine multimorbidity patterns, and a multimorbidity score for each resulting pattern was calculated. Adjusted multiple linear regression was used to examine the association between the identified multimorbidity and HRQoL scores by gender and for each age group (55-59, 60-64, 65-69, ≥ 70 years).
  
  
  RESULTS
  More than 63% of the sample reported two or more chronic conditions (from 55.8% for those 55-59 years to 74.4% for those ≥ 70 years). Multimorbidity was more common among women than men (67.3% vs 60%). Two different multimorbidity patterns were identified. Pattern A was represented mainly by mental illness and bone impairments. Pattern B was represented mainly by cardiovascular and metabolic disorders. After adjusting for covariates, a high pattern A score was associated with reduced HRQoL for the physical and mental components of each HRQoL questionnaire, and a high pattern B score was associated with reduced HRQoL for only the physical component of each questionnaire. These multimorbidity scores affected HRQoL differently by age group.
  
  
  CONCLUSIONS
  Our study used a novel methodological approach to account for multimorbidity patterns in determining the link with chronic conditions. These multimorbidity scores (counted and weighted) can be used in clinical research to control for the effect of multimorbidity on patients' HRQoL and may be useful for clinical practice.
  
  
  BACKGROUND
  Clinicaltrial.gov (number NCT00272428).
authors.affiliation: EA4360 APEMAC, University of Lorraine, University Paris Descartes, Nancy, France.
authors.forename: Valentin
authors.identifier: http://orcid.org/0000-0002-1314-6178
authors.initials: V
authors.lastname: Walker
authors.affiliation: EA4360 APEMAC, University of Lorraine, University Paris Descartes, Nancy, France.|Department of Gerontology, CHRU de Brabois, Nancy, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Perret-Guillaume
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle, Centre d'Epidémiologie et Statistiques Paris Cité, Université Paris 13, Inserm (U1153), Inra (U1125), COMUE Sorbonne-Paris-Cité, Bobigny, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.affiliation: EA4360 APEMAC, University of Lorraine, University Paris Descartes, Nancy, France.|CIC-1433 Epidémiologie Clinique, Inserm, CHRU Nancy, Nancy, France.
authors.forename: Nelly
authors.initials: N
authors.lastname: Agrinier
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle, Centre d'Epidémiologie et Statistiques Paris Cité, Université Paris 13, Inserm (U1153), Inra (U1125), COMUE Sorbonne-Paris-Cité, Bobigny, France.|Département de Santé Publique, Hôpital Avicenne, Bobigny, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle, Centre d'Epidémiologie et Statistiques Paris Cité, Université Paris 13, Inserm (U1153), Inra (U1125), COMUE Sorbonne-Paris-Cité, Bobigny, France.
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.affiliation: Equipe de Recherche en Epidémiologie Nutritionnelle, Centre d'Epidémiologie et Statistiques Paris Cité, Université Paris 13, Inserm (U1153), Inra (U1125), COMUE Sorbonne-Paris-Cité, Bobigny, France.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Assmann
authors.affiliation: EA4360 APEMAC, University of Lorraine, University Paris Descartes, Nancy, France.|CIC-1433 Epidémiologie Clinique, Inserm, CHRU Nancy, Nancy, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Briançon
authors.affiliation: EA4360 APEMAC, University of Lorraine, University Paris Descartes, Nancy, France.|CIC-1433 Epidémiologie Clinique, Inserm, CHRU Nancy, Nancy, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Rotonda
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires