Racial and Ethnic Differences in Multimorbidity Changes Over Time

Bibliographic Data

ID9103322
AuthorsAna R Quiñones (Department of Family Medicine), Ana Quinones (0000-0001-6554-7734, corresponding author), Jason T Newsom (0000-0001-8353-7468, Portland State University), Miriam R Elman (Osaka Health Science University), Miriam Elman (0000-0003-3162-6500), Sheila Markwardt (0000-0002-4929-4359, Osaka Health Science University), Corey L Nagel (University of Arkansas for Medical Sciences), Corey Nagel (0000-0003-3725-500X, University of Arkansas for Medical Sciences), David A Dorr (0000-0003-2318-7261, Osaka Health Science University), Heather Allore (0000-0001-7685-8175, Yale University), Heather G Allore (Department of Internal Medicine, School of Medicine), Anda Botoseneanu (0000-0003-0628-5820, University of Michigan, corresponding author)
Year2021
Volume59
Issue5
Pages402-409
Publication date2021-05-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001527
PMID33821829
OpenAlexW3136698021
LanguageEN
Citations received7
References cited28

BACKGROUND: Our understanding of how multimorbidity progresses and changes is nascent. OBJECTIVES: Assess multimorbidity changes among racially/ethnically diverse middle-aged and older adults. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study using latent class analysis to identify multimorbidity combinations over 16 years, and multinomial logistic models to assess change relative to baseline class membership. Health and Retirement Study respondents (age 51 y and above) in 1998 and followed through 2014 (N=17,297). MEASURES: Multimorbidity latent classes of: hypertension, heart disease, lung disease, diabetes, cancer, arthritis, stroke, high depressive symptoms. RESULTS: Three latent classes were identified in 1998: minimal disease (45.8% of participants), cardiovascular-musculoskeletal (34.6%), cardiovascular-musculoskeletal-mental (19.6%); and 3 in 2014: cardiovascular-musculoskeletal (13%), cardiovascular-musculoskeletal-metabolic (12%), multisystem multimorbidity (15%). Remaining participants were deceased (48%) or lost to follow-up (12%) by 2014. Compared with minimal disease, individuals in cardiovascular-musculoskeletal in 1998 were more likely to be in multisystem multimorbidity in 2014 [odds ratio (OR)=1.78, P<0.001], and individuals in cardiovascular-musculoskeletal-mental in 1998 were more likely to be deceased (OR=2.45, P<0.001) or lost to follow-up (OR=3.08, P<0.001). Hispanic and Black Americans were more likely than White Americans to be in multisystem multimorbidity in 2014 (OR=1.67, P=0.042; OR=2.60, P<0.001, respectively). Black compared with White Americans were more likely to be deceased (OR=1.62, P=0.01) or lost to follow-up (OR=2.11, P<0.001) by 2014. CONCLUSIONS AND RELEVANCE: Racial/ethnic older adults are more likely to accumulate morbidity and die compared with White peers, and should be the focus of targeted and enhanced efforts to prevent and/or delay progression to more complex multimorbidity patterns

Cohort · Cohort study · Comorbidity · Diabetes mellitus · Disease · Ethnic group · Latent class model · Odds ratio · Prospective cohort study · Stroke (engine) · Chronic Disease Management Strategies · Demography · Diabetes Management and Education · Internal Medicine · Medicine · Primary Care and Health Outcomes · Gerontology