Enfermedad crónica, mortalidad, discapacidad y pérdida de movilidad en ancianos españoles: estudio FRADEA / Chronic disease, mortality and disability in an elderly Spanish population: The FRADEA study

Introducción: El objetivo de nuestro trabajo fue analizar la asociación entre las principales enfermedades crónicas y la multimorbilidad, con mortalidad, discapacidad incidente en actividades básicas de la vida diaria y pérdida de movilidad en ancianos. Material y métodos: Novecientos cuarenta y tres participantes del estudio FRADEA con datos en la visita basal de enfermedades crónicas, y en la segunda visita de mortalidad, discapacidad incidente y pérdida de movilidad. Se analizó la asociación cruda y ajustada por edad, sexo y discapacidad previa entre el recuento de enfermedades crónicas total, el recuento de 14 enfermedades prevalentes preseleccionadas y la presencia de 2 o más de estas últimas (multimorbilidad) con los eventos adversos de salud referidos. Resultados: Los participantes con mayor recuento de enfermedades totales (OR 1,11; IC 95% 1,02-1,22), así como seleccionadas (OR 1,19; IC95% 1,03-1,38) tuvieron un mayor riesgo ajustado de mortalidad, pero no de discapacidad incidente ni pérdida de movilidad. Los sujetos con multimorbilidad tuvieron mayor riesgo ajustado, aunque no significativo, de mortalidad (HR 1,45; IC95% 0,87-2,43), frente a los que no la tenían. El tiempo medio libre de discapacidad incidente en participantes sin y conmultimorbilidad fue de 846 ± 34 y 731 ± 17 días respectivamente (log-rank 2 7,45; p = 0,006), y sin y con pérdida de movilidad fue de 818 ± 32 y 696 ± 13 días respectivamente (log-rank 2 10,99; p = 0,001). Conclusiones: La multimorbilidad no se asocia de manera ajustada con mortalidad, discapacidad incidente ni pérdida de movilidad en mayores de 70 años, aunque sí con mortalidad si se considera el recuento de enfermedades crónicas de manera lineal (AU)

Introduction: The objective of this study was to analyse the relationships between the major chronic diseases and multiple morbidity, with mortality, incident disability in basic activities of daily living, and loss of mobility in the elderly. Material and methods: A total of 943 participants were selected from the FRADEA Study, using available baseline data of chronic diseases, and at the follow-up visit of mortality, incident disability, and loss of mobility. The analysis was made of the unadjusted and adjusted association between the number of chronic diseases, the number of 14 pre-selected diseases, and the presence of two or more chronic diseases (multiple morbidity) with adverse health events recorded. Results: Participants with a higher number of diseases (OR 1.11; 95% CI: 1.02-1.22), and 14 preselected diseases (OR 1.19; 95% CI: 1.03-1.38) had a higher adjusted mortality risk, but not a higher incident disease or mobility loss risk. Subjects with multiple morbidity had a higher non-significant mortality risk (HR 1.45; 95% CI: 0.87-2.43), than those without multiple morbidity. Disability-free mean time in participants with and without multiple morbidity was 846 ± 34 and 731 ± 17 days, respectively (Log-rank 2 7.45. P =.006), and with our without mobility loss was 818±32 and 696±13 days, respectively (Log rank 2 10.99. P =.001). Conclusions: Multiple morbidity was not associated with mortality, incident disability in ADL, or mobility loss in adults older than 70 years, although if mortality is taken into account, the number of chronic diseases is linear (AU)

[Chronic disease, mortality and disability in an elderly Spanish population: the FRADEA study]. / Enfermedad crónica, mortalidad, discapacidad y pérdida de movilidad en ancianos españoles: estudio FRADEA.

INTRODUCTION: The objective of this study was to analyse the relationships between the major chronic diseases and multiple morbidity, with mortality, incident disability in basic activities of daily living, and loss of mobility in the elderly. MATERIAL AND METHODS: A total of 943 participants were selected from the FRADEA Study, using available baseline data of chronic diseases, and at the follow-up visit of mortality, incident disability, and loss of mobility. The analysis was made of the unadjusted and adjusted association between the number of chronic diseases, the number of 14 pre-selected diseases, and the presence of two or more chronic diseases (multiple morbidity) with adverse health events recorded. RESULTS: Participants with a higher number of diseases (OR 1.11; 95% CI: 1.02-1.22), and 14 pre-selected diseases (OR 1.19; 95% CI: 1.03-1.38) had a higher adjusted mortality risk, but not a higher incident disease or mobility loss risk. Subjects with multiple morbidity had a higher non-significant mortality risk (HR 1.45; 95% CI: 0.87-2.43), than those without multiple morbidity. Disability-free mean time in participants with and without multiple morbidity was 846±34 and 731±17 days, respectively (Log-rank χ(2) 7.45. P=.006), and with our without mobility loss was 818±32 and 696±13 days, respectively (Log rank χ(2) 10.99. P=.001). CONCLUSIONS: Multiple morbidity was not associated with mortality, incident disability in ADL, or mobility loss in adults older than 70 years, although if mortality is taken into account, the number of chronic diseases is linear.