Archives of Gerontology and Geriatrics, Год журнала: 2022, Номер 101, С. 104688 - 104688
Опубликована: Март 20, 2022
Язык: Английский
Alzheimer s & Dementia, Год журнала: 2021, Номер 17(5), С. 768 - 776
Опубликована: Янв. 6, 2021
Abstract Introduction We investigate dementia risk in older adults with different disease patterns and explore the role of inflammation apolipoprotein E ( APOE ) genotype. Methods A total 2,478 dementia‐free participants two or more chronic diseases (ie, multimorbidity) part Swedish National study on Aging Care Kungsholmen (SNAC‐K) were grouped according to their multimorbidity followed detect clinical dementia. The potential modifier effect C‐reactive protein (CRP) genotype was tested through stratified analyses. Results People neuropsychiatric , cardiovascular sensory impairment/cancer had increased hazards for compared unspecific (Hazard ration (HR) 1.66, 95% confidence interval [CI] 1.13‐2.42; 1.61, CI 1.17‐2.29; 1.32, 1.10‐1.71, respectively). Despite lack statistically significant interaction, high CRP within these patterns, being ε4 carriers heightened multimorbidity. Discussion Individuals neuropsychiatric, cardiovascular, are at ε4, may further increase risk. Identifying such high‐risk groups might allow tailored interventions prevention.
Язык: Английский
Процитировано
104
Frontiers in Public Health, Год журнала: 2023, Номер 11
Опубликована: Март 27, 2023
Social determinants of multimorbidity are poorly understood in clinical practice. This review aims to characterize the different patterns described literature while identifying social and behavioral that may affect their emergence subsequent evolution. We searched PubMed, Embase, Scopus, Web Science, Ovid MEDLINE, CINAHL Complete, PsycINFO Google Scholar. In total, 97 studies were chosen from 48,044 identified. Cardiometabolic, musculoskeletal, mental, respiratory most prevalent. Cardiometabolic profiles common among men with low socioeconomic status, mental complex found be more prevalent women. Alcohol consumption smoking increased risk multimorbidity, especially men. While association lower status is evident, mild related middle high also observed. The findings present point need for further addressing impact its population groups where this problem remains invisible (e.g., women, children, adolescents young adults, ethnic groups, disabled population, older people living alone and/or few relations), as well work heterogeneous samples (i.e., not only focusing on people) using robust methodologies better classification understanding patterns. Besides, inequalities urgently needed low- middle-income countries, currently understudied.
Язык: Английский
Процитировано
54
Mechanisms of Ageing and Development, Год журнала: 2020, Номер 192, С. 111383 - 111383
Опубликована: Окт. 9, 2020
Multimorbidity and depression are complex multifactorial conditions with major implications for older individuals, their families, healthcare providers. In this scoping review, we aimed to 1) review findings from longitudinal epidemiological studies investigating the association between multimorbidity depression; 2) identify potential mechanisms linking 3) discuss challenges advance research field. Overall, evidence emerging supports a bidirectional two conditions, although methodologically heterogeneous in terms of design, inclusion criteria, measurement depression, length follow-up. A variety biological, psychosocial, care-related drivers may regulate transition other way around, these yet be explicitly verified. Further is required unravel intricate interplay multimorbidity, common drivers, precipitating factors underlying relationship conditions. Understanding processes will inform strategies at promoting mental physical health during aging.
Язык: Английский
Процитировано
96
Thrombosis and Haemostasis, Год журнала: 2021, Номер 122(01), С. 142 - 150
Опубликована: Март 25, 2021
There are few large studies examining and predicting the diversified cardiovascular/noncardiovascular comorbidity relationships with stroke. We investigated stroke risks in a very prospective cohort of patients multimorbidity, using two common clinical rules, multimorbid index machine-learning (ML) approach, accounting for complex among variables, including dynamic nature changing risk factors.We studied U.S. 3,435,224 from medical databases 2-year investigation. Stroke outcomes were examined relationship to diverse conditions, demographic other inputs, ML multimorbidity factors, scores, index.Common scores had moderate comparable c indices training external validation samples (validation-CHADS2: 0.812, 95% confidence interval [CI] 0.808-0.815; CHA2DS2-VASc: 0.809, CI 0.805-0.812). A higher discriminant validity values both training/external (validation: 0.850, 0.847-0.853). The ML-based algorithms yielded highest gradient boosting/neural network logistic regression formulations no significant differences approaches (validation regression: 0.866, 0.856-0.876). Calibration formulation was satisfactory across wide range predicted probabilities. Decision curve analysis demonstrated that utility better than current rules newly developed tool. Also, models more clinically useful "treat all" strategy.Complex various comorbidities uncovered approach (and dynamic) changes have major consequences prediction. This may facilitate automated stratification presence helping decision-making process assessment integrated/holistic management.
Язык: Английский
Процитировано
88
Age and Ageing, Год журнала: 2021, Номер 50(6), С. 2183 - 2191
Опубликована: Июнь 3, 2021
the aim of this study was to examine cross-sectional and longitudinal associations different multimorbidity patterns with physical frailty in older adults.we used data from Swedish National on Aging Care Kungsholmen generate a measure, clusters participants similar were identified through fuzzy c-means cluster analyses. The association (n = 2,534) between measured logistic regression Six- 2,122) 12-year 2,140) determined multinomial analyses.six at baseline: psychiatric diseases; cardiovascular diseases, anaemia dementia; sensory impairments cancer; metabolic sleep disorders; musculoskeletal, respiratory gastrointestinal an unspecific pattern lacking any overrepresented diseases. Cross-sectionally, each associated compared pattern. Over 6 years, diseases (relative risk ratio [RRR]: 3.04; 95% confidence intervals [CI]: 1.59-5.79); dementia (RRR 2.25; CI: 1.13-4.49) disorders 1.99; 1.25-3.16) incident frailty. (RRR: 4.81; 1.59-14.60); 2.62; 1.45-4.72) cancer 1.87; 1.05-3.35) more frailty, pattern, over 12 years.we found that adults characterised by neuropsychiatric disease are most susceptible developing
Язык: Английский
Процитировано
76
Journal of Clinical Medicine, Год журнала: 2021, Номер 10(4), С. 766 - 766
Опубликована: Фев. 14, 2021
Multimorbidity refers to the coexistence of two or more chronic diseases in one person. Therefore, patients with multimorbidity have multiple and special care needs. However, practice it is difficult meet these needs because organizational processes current healthcare systems tend be tailored a single disease. To improve clinical decision making patient multimorbidity, radical change problem-solving approach medical research treatment needed. In addition traditional reductionist approach, we propose interactive supported by artificial intelligence (AI) advanced big data analytics. Such when applied routinely collected settings, provides an integrated platform for tasks related multimorbidity. This may include, example, prediction, correlation, classification problems based on interaction factors. realize idea this paradigm shift research, optimization, standardization, most importantly, integration electronic health into common national international infrastructure Ultimately, there need implementation efficient AI approaches, particularly deep learning, routine directly within workflows professionals.
Язык: Английский
Процитировано
65
Archives of Gerontology and Geriatrics, Год журнала: 2025, Номер 131, С. 105760 - 105760
Опубликована: Янв. 14, 2025
Язык: Английский
Процитировано
1
BMC Geriatrics, Год журнала: 2020, Номер 20(1)
Опубликована: Янв. 21, 2020
With increasing age, having multiple chronic conditions is the norm. It of importance to study how co-existence diseases affects functioning and mortality among older persons. Complex multimorbidity may be defined as three or more affecting at least different organ systems. The aim this was investigate complex activities daily living amongst Norwegians.Participants were 60-69-year-olds baseline in Nord-Trøndelag Health Study 1995-1997 (HUNT2) n = 9058. Multinomial logistic regression models used association between HUNT2, basic instrumental HUNT3 (2006-2008) during follow-up (n 5819/5836). Risk ratios (RR) risk differences (RD) percentage points (pp) with 95% confidence intervals (CI) reported.47.8% met criteria (HUNT2). Having strongly associated need for assistance IADL 11 years later (RR 1.80 (1.58-2.04) RD 8.7 (6.8-10.5) pp) moderately time 1.22 (1.12-1.33) 5.1 (2.9-7.3) pp). a lesser extent 1.24 (0.85-1.83) 0.4 (- 0.3-1.1) pp).This first show an living. should receive attention order prevent future disability
Язык: Английский
Процитировано
60
Aging Clinical and Experimental Research, Год журнала: 2021, Номер 33(2), С. 457 - 462
Опубликована: Фев. 1, 2021
Abstract The aim was to analyze the association between specific patterns of multimorbidity and risk disability in older persons. Data were gathered from Swedish National Study on Aging Care Kungsholmen (SNAC-K); 2066 60 + year-old participants living community free at baseline grouped according their followed-up for six years. basic (ADL) instrumental (IADL) activities daily examined through multinomial models. Throughout follow-up, 434 (21.0%) developed least one ADL 310 (15.0%) IADL. Compared unspecific pattern, which included diseases not exceeding expected prevalence total sample, belonging cardiovascular/anemia/dementia, sensory impairment/cancer musculoskeletal/respiratory/gastrointestinal associated with a higher developing both IADL, whereas subjects metabolic/sleep disorders pattern showed only Multimorbidity are differentially incident disability, is important design future prevention strategies aimed delaying functional impairment old age, better healthcare resource planning.
Язык: Английский
Процитировано
48
Scientific Reports, Год журнала: 2024, Номер 14(1)
Опубликована: Янв. 25, 2024
Abstract The prevalence of longstanding chronic diseases has increased worldwide, along with the average age population. As a result, an increasing number people is affected by two or more conditions simultaneously, and healthcare systems are facing challenge treating multimorbid patients effectively. Current therapeutic strategies suited to manage each condition separately, without considering whole clinical patient. This approach may lead suboptimal outcomes system inefficiencies (e.g. redundant diagnostic tests inadequate drug prescriptions). We develop novel methodology based on joint implementation data reduction clustering algorithms identify patterns that likely co-occur in multichronic patients. analyse from large adult population living Tuscany (Italy) 2019 which was stratified sex classes. Results demonstrate (i) cardio-metabolic, endocrine, neuro-degenerative represent stable pattern multimorbidity, (ii) disease vary across ages between women men. Identifying most common profiles can help tailor medical protocols patients’ needs reduce costs. Furthermore, analysing temporal refine risk predictions for evolutive conditions.
Язык: Английский
Процитировано
6