Document Detail


Change in comorbidity prevalence with advancing age among persons with heart failure.
MedLine Citation:
PMID:  21573881     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Comorbidity-a condition that co-exists with a primary illness-is common among older persons with heart failure and can complicate the overall management of this population.
OBJECTIVES: To determine the relationship between advancing age and the prevalence and patterns of comorbidity among older persons with heart failure.
DESIGN: Retrospective longitudinal cohort study
PARTICIPANTS: A total of 201,130 Medicare beneficiaries with heart failure stratified into three age strata in 2001: 66-75, 76-85, and 86+ years, and followed over 5 years.
MEASUREMENTS: (1) Prevalence of 19 conditions as identified by the Chronic Conditions Warehouse from Medicare claims data, characterized as concordant (related to heart failure) or discordant (unrelated to heart failure), and (2) overall comorbidity burden, defined as count of conditions.
RESULTS: The median number of comorbidities rose from four (IQR: 2-5) to five (IQR: 4-7) among the young-old, and from 4 (IQR: 3-6) to 6 (IQR: 5-8) among the middle-old and oldest-old between 2001 and 2006. In 2001, the majority of concordant conditions were more prevalent among the youngest than oldest beneficiaries (e.g., diabetes 46.2% vs 26.9%; kidney disease 21.8% vs 18.4%), while the majority of discordant conditions were more prevalent among the oldest-old than youngest-old beneficiaries (e.g., dementia 39.6% vs 9.9%; hip fracture 9.5% vs 1.9%). Discordant conditions increased in prevalence faster among the oldest than youngest beneficiaries (e.g., dementia 13% points versus 9% points).
CONCLUSION: Among older Medicare beneficiaries with heart failure, there is a higher overall burden of comorbidity and greater prevalence of discordant comorbidity among the oldest old. Comorbidity prevalence increases over time, with discordant comorbidity increasing at the fastest rate among the oldest old. This comorbidity burden highlights the challenge of effectively treating heart failure while simultaneously managing co-existing and unrelated conditions.
Authors:
Sangeeta C Ahluwalia; Cary P Gross; Sarwat I Chaudhry; Linda Leo-Summers; Peter H Van Ness; Terri R Fried
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-05-15
Journal Detail:
Title:  Journal of general internal medicine     Volume:  26     ISSN:  1525-1497     ISO Abbreviation:  J Gen Intern Med     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-28     Completed Date:  2012-02-07     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1145-51     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aging / pathology*
Cohort Studies
Comorbidity
Dementia / epidemiology,  pathology
Diabetes Mellitus / epidemiology,  pathology
Female
Heart Failure / epidemiology*,  pathology*
Hip Fractures / epidemiology,  pathology
Humans
Kidney Diseases / epidemiology,  pathology
Longitudinal Studies
Male
Prevalence
Retrospective Studies
Grant Support
ID/Acronym/Agency:
2P30AG021342-06/AG/NIA NIH HHS; K23 AG030986/AG/NIA NIH HHS; K23AG030986/AG/NIA NIH HHS; K24 AG028443/AG/NIA NIH HHS; T32AG1934/AG/NIA NIH HHS
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