Effects of Disease Burden and Functional Adaptation on Morbidity and Mortality on Older Adults

Objectives To ascertain whether older adults with extensive disease but relative vigor (adapters) shorten the period at the end of life in which they live with morbidity (compress morbidity). Design Prospective, community‐based cohort study in four U.S. cities. Setting Cardiovascular Health Study. P...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2016-06, Vol.64 (6), p.1242-1249
Main Authors: Sanders, Jason L., Arnold, Alice M., Hirsch, Calvin H., Thielke, Stephen M., Kim, Dae, Mukamal, Kenneth J., Kizer, Jorge R., Ix, Joachim H., Kaplan, Robert C., Kritchevsky, Stephen B., Newman, Anne B.
Format: Article
Language:English
Subjects:
Adaptation
Adaptation, Physiological
Aged
Aged, 80 and over
Disability Evaluation
Disease
Female
Frail Elderly
Frailty
function
Geriatric Assessment
Geriatrics
Humans
longevity
Male
Morbidity
Mortality
Older people
Prospective Studies
Survival analysis
United States - epidemiology
Vigor
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Summary:Objectives To ascertain whether older adults with extensive disease but relative vigor (adapters) shorten the period at the end of life in which they live with morbidity (compress morbidity). Design Prospective, community‐based cohort study in four U.S. cities. Setting Cardiovascular Health Study. Participants Individuals aged 65 and older. Measurements Participants were categorized into three groups according to extent of disease (assessed noninvasively), vigor, and frailty (expected agers (n = 3,528, extent of disease similar to vigor and frailty—reference group), adapters (n = 882, higher disease but vigorous), and prematurely frail (n = 855, lower disease but frail)) and compared according to years of able life (YAL), years of self‐reported healthy life (YHL), and mortality using multivariable regression and survival analysis. Results After adjustment, adapters had 0.97 (95% confidence interval (CI) = 0.60–1.33) more YAL and 0.54 (95% CI = 0.19–0.90) more YHL than expected agers, and those who were prematurely frail had −0.99 (95% CI = −1.36 to −0.62) fewer YAL and −0.53 (95% CI = −0.89 to −0.17) fewer YHL than expected agers. Adapters had 0.9 more and prematurely frail had 1.5 fewer years of total life than expected agers (P 
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.14163