Multimorbidity patterns and mortality in older adults: Results from the KORA-Age study

Frontiers in Nutrition

Nutrition

Karl-Heinz Ladwig¹  Birgit Linkohr²  Barbara Thorand³  Ava Arshadipour⁴  Annette Peters⁵  Margit Heier⁶ 

[1] Department for Psychosomatic Medicine and Psychotherapy, Klinikum Rechts Der Isar, Technical University of München, Munich, Germany;Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany;Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany;German Center for Diabetes Research (DZD), Neuherberg, Germany;Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany;Institute for Medical Information Processing Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany;Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany;Institute for Medical Information Processing Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany;German Center for Diabetes Research (DZD), Neuherberg, Germany;German Center for Cardiovascular Disease Research (DZHK), Munich, Germany;Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany;KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany;

关键词: chronic disease;    multimorbidity;    mortality;    older people;    sex differences;    hazard ratios;   

DOI  :  10.3389/fnut.2023.1146442

 received in 2023-01-17, accepted in 2023-03-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

The coexistence of several chronic diseases is very common in older adults, making it crucial to understand multimorbidity (MM) patterns and associated mortality. We aimed to determine the prevalence of MM and common chronic disease combinations, as well as their impact on mortality in men and women aged 65 years and older using the population-based KORA-Age study, based in South of Germany. The chronic disease status of the participants was determined in 2008/9, and mortality status was followed up until 2016. MM was defined as having at least two chronic diseases. We used Cox proportional hazard models to calculate the hazard ratios (HRs) and the 95% confidence intervals (CIs) for associations between MM and all-cause mortality. During the study period 495 men (24.6%) and 368 women (17.4%) died. Although the MM prevalence was almost the same in men (57.7%) and women (60.0%), the overall effect of MM on mortality was higher in men (HR: 1.81, 95% CI: 1.47–2.24) than in women (HR: 1.28, 95% CI: 1.01–1.64; p-value for interaction <0.001). The type of disease included in the MM patterns had a significant impact on mortality risk. For example, when both heart disease and diabetes were included in the combinations of two and three diseases, the mortality risk was highest. The risk of premature death does not only depend on the number of diseases but also on the specific disease combinations. In this study, life expectancy depended strongly on a few diseases, such as diabetes, hypertension, and heart disease.

【 授权许可】

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Copyright © 2023 Arshadipour, Thorand, Linkohr, Ladwig, Heier and Peters.