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Investigating Frailty, Polypharmacy, Malnutrition, Chronic Conditions, and Quality of Life in Older Adults: Large Population-Based Study.

BACKGROUND: Aging, a significant public health issue, is associated with multiple concurrent chronic diseases and aging-related conditions (geriatric syndromes). OBJECTIVE: This study aims to investigate the impact of age and chronic conditions on geriatric syndromes and the intercorrelations between multiple geriatric syndromes and quality of life (QoL) in older adults (aged ≥65 years) at the population level. METHODS: A large representative sample was randomly selected from a county in China, Feidong, with 17 towns and 811,867 residents. Multiple chronic conditions, geriatric syndromes (fr…

Контекст коммуникации в области здравоохранения в случае хронических заболеваний.

Чрезвычайно важным элементом эффективного лечения хронических заболеваний является общение между пациентами и специалистами. Вместе с тем не вполне понятно, как развивалась коммуникационная деятельность в области здравоохранения в поддержку самообслуживания и эффективной борьбы с различными хроническими заболеваниями. В рамках настоящего исследования была проанализирована связь в области здравоохранения с точки зрения 38 пациентов, страдающих четырьмя различными хроническими заболеваниями: почечными заболеваниями на конечной стадии (ЭСРД), сахарным диабетом, не связанным с инсулином (НИДДМ), м

Multimorbidity at time of death among persons with type 2 diabetes: a population-based study in Ontario, Canada.

OBJECTIVE: Individuals with Type 2 Diabetes are likely to experience multimorbidity and accumulate multiple chronic conditions over their life. We aimed to identify causes of death and chronic conditions at the time of death in a population-based cohort, and to analyze variations in the presence of diabetes at the time of death overall and across income and immigrant status. RESEARCH DESIGN AND METHODS: We conducted a retrospective cohort study of 2,199,801 adult deaths from 1992 to 2017 in Ontario, Canada. We calculated the proportion of decedents with chronic conditions at time of death and…

Epidemiology of regular prescribed opioid use: results from a national, population-based survey.

Chronic pain occurs commonly and accounts for significant suffering and costs. Although use of opioids for treatment of chronic pain is increasing, little is known about patients who use opioids regularly. We report data from the second wave of the Healthcare for Communities survey (2000-2001), a large, nationally representative household survey. We compared regular users of prescription opioids to nonusers of opioids and calculated the percentage of individuals within a given demographic or disease state that reported chronic opioid use. Approximately 2% of the 7,909 survey respondents report

Magnitude of multiple drug use and determinants of vulnerability among chronic kidney disease inpatients in Ethiopia: a multi-center study.

BACKGROUND: Patients with chronic kidney disease frequently face various nutritional and metabolic problems that necessitate the use of multiple medications. This multiple drug use can lead to several drug-related problems including adverse drug events, hospital admissions, poor medication adherence, harmful drug interactions, inadequate therapeutic outcomes, and death. Despite these challenges, there is a notable lack of studies on the extent of multiple drug use and its determinants among patients with chronic kidney disease in Ethiopia. This study aims to assess the magnitude of multiple dr

Health-care use and cost for multimorbid persons with dementia in the National Health and Aging Trends Study.

BACKGROUND: Most persons with dementia have multiple chronic conditions; however, it is unclear whether co-existing chronic conditions contribute to health-care use and cost. METHODS: Persons with dementia and ≥2 chronic conditions using the National Health and Aging Trends Study and Medicare claims data, 2011 to 2014. RESULTS: Chronic kidney disease and ischemic heart disease were significantly associated with increased adjusted risk ratios of annual hospitalizations, hospitalization costs, and direct medical costs. Depression, hypertension, and stroke or transient ischemic attack were asso…

Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study.

Enhancing daily functioning and well-being is an increasingly advocated goal in the treatment of patients with chronic conditions. We evaluated the functioning and well-being of 9385 adults at the time of office visits to 362 physicians in three US cities, using brief surveys completed by both patients and physicians. For eight of nine common chronic medical conditions, patients with the condition showed markedly worse physical, role, and social functioning; mental health; health perceptions; and/or bodily pain compared with patients with no chronic conditions. Each condition had a unique prof

An Examination of Comorbid Generalized Anxiety Disorder and Chronic Pain on Substance Misuse in a Canadian Population-Based Survey.

OBJECTIVES: Chronic pain and generalized anxiety disorder (GAD) are co-occurring, and both conditions are independently associated with substance misuse. However, limited research has examined the impact of comorbid GAD and chronic pain on substance misuse. The aim of this article was to examine the associations between comorbid GAD and chronic pain conditions compared to GAD only with nonmedical opioid use, drug abuse/dependence, and alcohol abuse/dependence in a Canadian, population-based sample. METHODS: Data came from the 2012 Canadian Community Health Survey-Mental Health (N = 25,113). M

Thalidomide for the treatment of chronic refractory prurigo nodularis.

Prurigo nodularis (PN) is a highly pruritic skin condition that is caused by chronic scratching. It occurs in patients with chronic itch and is characterized by multiple hyperkeratotic papules and nodules. The pathogenesis of PN is unclear, but involves a complex interplay of numerous pathways including neurogenic and inflammatory factors. As such, PN is very difficult to treat and patients are often refractory to multiple medications before finding a treatment that is effective. We present a woman with a 20-year history of exuberant prurigo nodularis who failed multiple therapies, including d

Midterm outcomes of sleeve gastrectomy in the elderly.

BACKGROUND: The increase in life expectancy presents health systems with a growing challenge in the form of elderly obesity. Bariatric surgery has been shown to be a safe and effective treatment for obesity with reduction of excess weight and improvement in obesity-related co-morbidities. However, only recently have surgeons begun performing these operations on elderly patients on a larger scale, making data regarding mid- and long-term outcomes scarce. The objective of this study was to evaluate the safety and midterm efficacy of laparoscopic sleeve gastrectomy (LSG) in patients aged ≥60 year

Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland.

OBJECTIVES: The burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact. DESIGN: A large cross-sectional population-based study. SETTING: Community in 2 regions of French-speaking Switzerland. PARTICIPANTS: Community-dwelling older adults aged 68 years and older in 2011 (N=5300). OUTC

Patient Barriers to Accessing Surgical Cleft Care in Vietnam: A Multi-site, Cross-Sectional Outcomes Study.

BACKGROUND: Most people who lack adequate access to surgical care reside in low- and lower-middle-income countries. Few studies have analyzed the barriers that determine the ability to access surgical treatment. We seek to determine which barriers prevent access to cleft care in a resource-limited country to potentially enable barrier mitigation and improve surgical program design. METHODS: A cross-sectional, multi-site study of families accessing care for cleft lip and palate deformities was performed in Vietnam. A survey instrument containing validated demographic, healthcare service access

Cumulative Childhood Adversity as a Risk Factor for Common Chronic Pain Conditions in Young Adults.

OBJECTIVE: Multiple and specific types of childhood adverse events are risk factors for chronic pain conditions. Although both can covary, no study has evaluated one aspect while controlling for the other. Therefore, the current study examined whether more adverse events would be a risk factor for common chronic pain conditions and pain medication use in young adults after controlling for different adversity types such as physical, emotional, and sexual traumatic events or vice versa. METHODS: This cross-sectional study recruited 3,073 undergraduates (72% female, mean age = 18.8 years, SD = 1

A population-based examination of suicidality in comorbid generalized anxiety disorder and chronic pain.

BACKGROUND: Generalized anxiety disorder (GAD) and chronic pain conditions commonly co-occur, and are both independently associated with suicidality; however, little is known about the impact of chronic pain on suicidality among individuals with GAD. The aim of this study was to examine the associations between comorbid GAD and chronic pain conditions with suicide ideation, plans, and attempts in a population-based sample. METHODS: We analyzed data from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH; N = 25,113). Multiple logistic regressions examined the associations betwee

Secondary health conditions and social role satisfaction in adults with long-term physical disability.

OBJECTIVE: Individuals living with physical disability due to early acquired or traumatic conditions often experience a range of psychological and physical health problems that are associated with their condition but are not directly caused by it. Known as "secondary health conditions," these problems can interact with existing functional limitations and other medical comorbidities to limit social participation. The current study assessed the concurrent and longitudinal associations between secondary health conditions, chronic medical comorbidities, and functional limitations, with a PROMIS® m

Impact of Risk Factor Combinations on Severe COVID-19 Outcomes Among Outpatients.

INTRODUCTION: Several risk factors for progression to severe COVID-19 have been identified, but whether multiple concomitant risk factors (risk stacking) further increase risk remains unknown. We sought to identify outpatient populations at the highest risk for severe COVID-19 using risk factor stacking. METHODS: We conducted a retrospective cohort study of Veterans Affairs (VA) outpatient adults (≥ 18 years) at high risk for severe COVID-19 with a positive SARS-CoV-2 test or COVID-19 diagnosis between April 1, 2022 and August 21, 2024. Severe COVID-19 was defined as COVID-19-related hospital

Chronic Conditions and Patient-Centered Outcomes After Transcatheter Aortic Valve Intervention.

BACKGROUND: Transcatheter aortic valve intervention (TAVI) has revolutionized the care of older adults with aortic stenosis. OBJECTIVES: Th … re eligible for linkage with Centers for Medicare & Medicaid Services claims data. The exposure was multiple chronic conditions (MCCs) in the year before TAVI. Associations between chronic conditions and outcomes were assessed using multivariable logistic regression. RESULTS: A total of 188,629 TAVI procedures were linked to Centers for Medicare & Medicaid Services claims. …

Fatigue across physical and mental health conditions: results from a multicenter study at the German Center for Mental Health.

BACKGROUND: Fatigue is a frequent and disabling symptom across many physical and mental health conditions. Despite similar phenomenology, research has largely focused on single conditions using heterogeneous assessments, limiting cross-condition comparability. This study examines fatigue-related symptom burden across diverse clinical conditions within a shared framework. METHODS: In this multicenter cross-sectional study, adult outpatients (18-65 years) were recruited at five German university hospitals into seven cohorts: chronic primary pain, multiple sclerosis, cancer, chronic renal failur

Patterns of multimorbidity in older adults with multiple myeloma: An analysis of SEER-Medicare.

OBJECTIVE: Multimorbidity influences the management of symptoms, treatment, and health outcomes for older adults with multiple myeloma. Our study characterized patient profiles defined by discrete chronic condition patterns and examined the distribution of their sociodemographic factors in older adults at time of diagnosis with multiple myeloma. METHODS: Using the Surveillance, Epidemiology and End Results (SEER) Program database linked with Medicare insurance claims (2007-2017), we examined 11,926 individuals diagnosed with multiple myeloma at age ≥ 65 years. Hierarchical cluster analysis wa

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… Count-based methods may not account for the complex manifestation of multiple chronic conditions [ 18 , 19 ] and mainstream comorbidity indices may be limited in their ability to granularly examine multimorbidity in older adults [ 20 ], as they include a limited number of chronic conditions and may be … Beyond counting the number of chronic conditions, different approaches are needed to better define and understand the nature and impact of multiple chronic conditions. Making treatment decisions that account for the complexity of having multiple chronic conditions is often challenging. …

Multiple myeloma in primary biliary cirrhosis.

A patient who had primary biliary cirrhosis and, simultaneously, multiple myeloma (IgG, lambda) is reported. In chronic liver diseases, polyclonal hypergammaglobulinaemia is common, monoclonal gammopathies have also been found in rare instances, being attributed to chronic antigenic stimulation of the reticuloendothelial system by antigens from the intestinal flora. The mechanisms (as chronic antigenic stimulation, immunologic disturbances and granulomata formation) which apply to explain the development of monoclonal gammopathies in other conditions are also found in primary biliary cirrhosis