Chronic health conditions and mortality among older adults with complex care needs in Aotearoa New Zealand

BMC Geriatrics

Research

Ngaire Kerse¹  Ruth Teh¹  Hans Ulrich Bergler²  Hamish A Jamieson²  Rebecca Abey-Nesbit²  John W Pickering² 

[1] Department of General Practice and Primary Health Care, University of Auckland, M&HS Building 507 - Bldg 507, 28 Park Ave, Grafton, 1850, 1023, Auckland, New Zealand;Department of Medicine, University of Otago, Christchurch, New Zealand;

关键词: Mortality;    Ageing;    Comorbidities;    interRAI;    Geriatric assessment;   

DOI  :  10.1186/s12877-023-03961-8

 received in 2022-11-16, accepted in 2023-04-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOlder people have more comorbidities than younger groups and multimorbidity will increase. Often chronic conditions affect quality of life, functional ability and social participation. Our study aim was to quantify the prevalence of chronic conditions over a three-year period and their association with mortality after accounting for demographics.MethodsWe conducted a retrospective cohort study using routinely collected health data including community-dwelling older adults in New Zealand who had an interRAI Home Care assessment between 1 January 2017 and 31 December 2017. Descriptive statistics and differences between variables of interest among ethnic groups were reported. Cumulative density plots of mortality were developed. Logistic regression models adjusted for age and sex to estimate mortality were created independently for each combination of ethnicity and disease diagnosis.ResultsThe study cohort consisted of 31,704 people with a mean (SD) age of 82.3 years (8.0), and of whom 18,997 (59.9%) were female. Participants were followed for a median 1.1 (range 0 to 3) years. By the end of the follow-up period 15,678 (49.5%) people had died. Nearly 62% of Māori and Pacific older adults and 57% of other ethnicities had cognitive impairment. Diabetes the next most prevalent amongst Māori and Pacific peoples, and coronary heart disease amongst Non-Māori/Non-Pacific individuals. Of the 5,184 (16.3%) who had congestive heart failure (CHF), 3,450 (66.6%) died. This was the highest mortality rate of any of the diseases. There was a decrease in mortality rate with age for both sexes and all ethnicities for those with cancer.ConclusionsCognitive impairment was the most common condition in community dwelling older adults who had an interRAI assessment. Cardiovascular disease (CVD) has the highest mortality risk for all ethnic groups, and in non-Māori/non-Pacific group of advanced age, risk of mortality with cognitive impairment is as high as CVD risk. We observed an inverse for cancer mortality risk with age. Important differences between ethnic groups are reported.

【 授权许可】

CC BY   
© The Author(s) 2023

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