Multimorbidity and Functional Limitations Among Adults 65 or Older, NHANES 2005–2012
ORIGINAL RESEARCH — Volume 13 — November 3, 2016
PEER REVIEWED
Figure 1. Predicted mean number of limitations by the number of chronic conditions, stratified by sex and age group, National Health and Nutrition Examination Survey 2005–2012, for all 19 limitations and for ADL and IADL (7 limitations) only. Negative binomial regression was used to estimate the association between multimorbidity and functional limitation, adjusted for age, body mass index, and smoking. Abbreviations: ADL, activities of daily living; IADL, instrumental activities of daily living.
| No. of Chronic Conditions | Men | Women | ||
|---|---|---|---|---|
| Aged 65–74 y | Aged ≥75 y | Aged 65–74 y | Aged ≥75 y | |
| For all 19 limitations | ||||
| 0 | 1.07 | 1.80 | 1.22 | 2.02 |
| 1 | 1.51 | 2.27 | 1.80 | 2.66 |
| 2 | 2.07 | 2.96 | 2.64 | 3.71 |
| 3 | 2.91 | 3.71 | 3.93 | 4.97 |
| 4 | 3.92 | 4.84 | 5.66 | 6.72 |
| 5 | 5.55 | 6.26 | 8.03 | 9.00 |
| 6 | 7.27 | 7.94 | 11.8 | 12.4 |
| 7 | 10.1 | 10.9 | 22.0 | 16.5 |
| 8 | 11.2 | 20.1 | 22.8 | 25.2 |
| For ADL and IADL only | ||||
| 0 | 0.28 | 0.49 | 0.28 | 0.49 |
| 1 | 0.41 | 0.66 | 0.44 | 0.70 |
| 2 | 0.58 | 0.90 | 0.68 | 1.03 |
| 3 | 0.85 | 1.19 | 1.08 | 1.50 |
| 4 | 1.20 | 1.63 | 1.63 | 2.17 |
| 5 | 1.74 | 2.21 | 2.49 | 3.14 |
| 6 | 2.41 | 2.91 | 3.81 | 4.59 |
| 7 | 3.47 | 4.20 | 7.47 | 6.80 |
| 8 | 4.15 | 8.06 | 8.82 | 10.1 |
Figure 2. Prevalence of 9 chronic conditions, by age and sex, among adults aged ≥65, National Health and Nutrition Examination Survey, 2005–2012. For pairwise comparisons of prevalence between sexes in each age group and between age groups of each sex, we found the following significant differences using a Bonferroni-corrected P value of <.001: between sexes in both age groups for CVD and arthritis; between women’s age groups for CVD; between women’s age groups for stroke and hypertension; between men’s age group for cancer. Error bars are 95% confidence intervals. Abbreviations: CKD, chronic kidney disease; CVD, cardiovascular disease.
| Sex and Age | Arthritis | Cancer | Cardiovascular Disease | Chronic Kidney Disease | Depression | Diabetes | Hypertension | Pulmonary Disease | Stroke |
|---|---|---|---|---|---|---|---|---|---|
| Men aged 65–74 | 44 (40–48) | 23 (20–26) | 25 (22–29) | 4 (3–6) | 4 (3–5) | 25 (22–28) | 58 (54–61) | 19 (16–22) | 8 (6–10) |
| Women aged 65–74 | 60 (57–63) | 21 (19–24) | 12 (10–14) | 4 (3–6) | 6 (5–8) | 21 (18–25) | 59 (55–62) | 23 (19–27) | 5 (4–6) |
| Men aged ≥75 | 48 (45–51) | 36 (32–40) | 33 (29–37) | 6 (4–8) | 3 (2–4) | 21 (18–25) | 60 (56–63) | 17 (15–21) | 11 (9–14) |
| Women aged ≥75 | 63 (59–66) | 28 (25–32) | 21 (17–24) | 4 (3–6) | 5 (4–6) | 20 (18–23) | 69 (65–72) | 17 (15–20) | 12 (9–16) |
Figure. Prevalence among older adults of having difficulty performing 19 activities, by age group, National Health and Nutrition Examination Survey (NHANES), 2005–2012. The list of activities was derived from 19 NHANES questionnaire items, grouped into 5 domains, used to assess functional status. Responses to each question were dichotomized as either having no difficulty or having difficulty (some difficulty, much difficulty, or “unable to do”). For example, if the prevalence among adults aged 65 to 74 of having difficulty getting in and out of bed was 11%, then the prevalence of not having difficulty was 89%.
| Domain/Activity | Has Difficult With Activity | |
|---|---|---|
| Aged 65–74 y | Aged ≥ 75 y | |
| Activities of daily living | ||
| Getting in and out of bed | 11 | 18 |
| Using fork, knife, drinking from cup | 3 | 8 |
| Walking between rooms on same floor | 7 | 15 |
| Dressing yourself | 9 | 15 |
| Instrumental activities of daily living | ||
| House chores | 18 | 28 |
| Managing money | 6 | 11 |
| Preparing meals | 6 | 13 |
| Leisure and social activities | ||
| Going out to movies, events | 14 | 23 |
| Leisure activity at home | 4 | 7 |
| Attending social events | 10 | 16 |
| Lower-extremity mobility | ||
| Walking up 10 steps | 24 | 43 |
| Walking for a quarter-mile | 30 | 50 |
| General physical activities | ||
| Grasping or holding small objects | 14 | 19 |
| Lifting or carrying | 18 | 30 |
| Reaching up over head | 14 | 20 |
| Sitting for long periods | 15 | 15 |
| Standing for long periods | 36 | 55 |
| Standing up from armless chair | 18 | 30 |
| Stooping, crouching, kneeling | 44 | 58 |
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