- By Bob Nellis
Multi-Institutional Research Team Measures Multiple Morbidities
Journalists: Sound bites with Dr. Rocca are in the downloads.
ROCHESTER, Minn. — A collaborative study by researchers from Mayo Clinic, Olmsted Medical Center and Johns Hopkins University has measured multimorbidity — multiple diseases or medical conditions co-occurring in a single patient — and has determined which combinations of medical conditions are more prevalent by age, sex, and race/ethnicity in a geographically-defined Midwestern population. Investigators say that their findings, published in Mayo Clinic Proceedings, are valuable in light of the aging population, the need to plan and prioritize health care interventions, and have broad implications for clinical research.
Using a list of 20 medical conditions developed by the U.S. Department of Health and Human Services, the research team accessed records for over 138,000 persons who lived in Olmsted County, Minnesota, during 2010 via the Rochester
Epidemiology Project. They concluded that multimorbidity is fairly common in the general population; it increases steeply with older age; has different combinations in men and women; and varies by race/ethnicity.
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“This is the first comprehensive assessment of combinations of medical conditions in our community,” says Mayo Clinic neurologist and epidemiologist Walter Rocca, M.D. “Clinical guidelines that focus on a single chronic disease should be reconsidered to include multiple risk factors and combinations of diseases. Attention to multiple morbidities may mean changing treatment approaches, the use of medications, or the organization of medical services.”
Some key findings:
- Of the study subjects, 39 percent had one or more of the conditions, 23 percent had two or more conditions, and nearly 5 percent had five or more conditions.
- The number of people affected by multimorbidity was higher in people younger than age 65 compared to people 65 or older.
- Multimorbidity was higher in blacks than in whites, and in whites than in Asians.
- Combinations of two or three conditions that included arthritis and osteoporosis were more common in women; combinations that included cancer were more common in men.
- Most combinations in persons younger than 60 included mental disorders, such as depression and substance abuse.
- Among children and young men and women up to age 19, the most common conditions were depression, substance abuse and asthma.
The most common combinations in persons older than 60 included hypertension, hyperlipidemia, diabetes and coronary artery disease. While the study is regional, the findings compare closely with findings from the Medicare database and with those from a recent similar study in Scotland. Researchers say that because the study included 97 percent of Rochester’s U.S. census population, the study reflects the situation in the entire county population. The findings can be extrapolated to other populations with similar demographic characteristics.
The research was made possible by the Rochester Epidemiology Project, which is supported by the National Institute on Aging-National Institutes of Health. Additional support was received from the Paul Beeson Career Development Award Program of the National Institute on Aging, the John A. Hartford Foundation, Atlantic Philanthropies, the Starr Foundation, and an anonymous donor.
Co-authors include Brandon Grossardt, William Bobo, M.D., Lila Finney Rutten, Ph.D., Veronique Roger, M.D., Jon Ebbert, M.D., Terry Therneau, Ph.D., and Jennifer St. Sauver, Ph.D., all of Mayo Clinic; Cynthia Boyd, M.D., Johns Hopkins University; and Barbara Yawn, M.D., Olmsted Medical Center.
About Mayo Clinic
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