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Patterns of Co-Occurrence of Chronic Disease Among Older Adults in Tokyo, Japan

CME ACTIVITY — Volume 16 — January 31, 2019

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Figure 1.
The 15 most common 3-way chronic disease patterns among men aged 75 or older in Tokyo, Japan (N = 505,057) by rank and age group with average number of chronic diseases and annual number of outpatient facilities visited, hospital admissions, and outpatient medical expenditures. Percentages do not total 100 because of rounding. Source: Tokyo Extended Association of Medical Care System for the Latter-Stage Elderly People (14). Abbreviation: SD, standard deviation.

Rank Three-Way Patterns Of Chronic Disease n (%) Age, y % Number of Chronic Diseases, Mean (SD) Number of Outpatient Facilities Visited, Mean (SD) Number of Admissions, Mean (SD) Total Outpatient Medical Expenditure (US$), Mean (SD)
1 Hypertension, peptic ulcer disease, coronary heart disease 62,480 (12.4) 75–79 11.0 6.5 (1.7) 3.6 (2.1) 0.7 (1.2) 7,208 (8,345)
80–84 13.8
85–89 14.2
90–94 13.0
95–99 10.4
≥100 7.4
2 Hypertension, dyslipidemia, peptic ulcer disease 55,741 (11.0) 75–79 11.1 6.4 (1.7) 3.6 (2.1) 0.6 (1.1) 6,464 (6,726)
80–84 12.1
85–89 10.4
90–94 7.5
95–99 4.3
≥100 2.9
3 Hypertension, dyslipidemia, coronary heart disease 54,460 (10.8) 75–79 10.6 6.3 (1.8) 3.5 (2.0) 0.6 (1.1) 6,211 (6,645)
80–84 11.8
85–89 10.7
90–94 8.0
95–99 4.9
≥100 2.4
4 Hypertension, peptic ulcer disease, cerebrovascular accident 46,798 (9.3) 75–79 7.9 6.5 (1.8) 3.7 (2.1) 0.7 (1.2) 6,783 (7,226)
80–84 10.4
85–89 11.4
90–94 10.5
95–99 8.6
≥100 6.6
5 Hypertension, peptic ulcer disease, urologic disease 41,346 (8.2) 75–79 6.7 6.6 (1.8) 4.1 (2.2) 0.7 (1.2) 7,100 (5,971)
80–84 9.4
85–89 10.4
90–94 10.1
95–99 7.6
≥100 6.2
6 Dyslipidemia, peptic ulcer disease, coronary heart disease 41,263 (8.2) 75–79 8.0 6.6 (1.7) 3.7 (2.1) 0.7 (1.2) 6,861 (7,345)
80–84 9.1
85–89 8.1
90–94 6.1
95–99 3.6
≥100 2.0
7 Hypertension, peptic ulcer disease, cancer 38,295 (7.6) 75–79 6.7 6.5 (1.8) 3.9 (2.1) 1.0 (1.4) 8,035 (8,193)
80–84 8.8
85–89 8.5
90–94 7.2
95–99 5.1
≥100 3.4
8 Hypertension, dyslipidemia, cerebrovascular accident 37,825 (7.5) 75–79 7.0 6.4 (1.8) 3.6 (2.1) 0.6 (1.1) 6,052 (5,851)
80–84 8.5
85–89 8.0
90–94 5.9
95–99 3.7
≥100 2.2
9 Hypertension, cerebrovascular accident, coronary heart disease 37,755 (7.5) 75–79 6.0 6.7 (1.8) 3.7 (2.1) 0.7 (1.2) 6,877 (7,586)
80–84 8.5
85–89 9.7
90–94 9.4
95–99 8.2
≥100 5.4
10 Hypertension, peptic ulcer disease, osteoarthritis/spine disorder 37,352 (7.4) 75–79 6.6 6.6 (1.8) 4.4 (2.3) 0.7 (1.1) 7,400 (7,316)
80–84 8.4
85–89 8.3
90–94 7.3
95–99 5.5
≥100 4.0
11 Hypertension, peptic ulcer disease, hyperuricemia 33,579 (6.6) 75–79 6.3 6.6 (1.8) 3.5 (2.0) 0.7 (1.2) 6,694 (7,121)
80–84 7.3
85–89 6.8
90–94 6.1
95–99 4.5
≥100 2.5
12 Hypertension, urologic disease, coronary heart disease 33,331 (6.6) 75–79 5.1 6.8 (1.8) 4.0 (2.2) 0.7 (1.2) 7,006 (6,557)
80–84 7.6
85–89 9.1
90–94 8.7
95–99 7.1
≥100 4.9
13 Hypertension, dyslipidemia, diabetes mellitus 33,067 (6.5) 75–79 7.4 6.2 (1.9) 3.2 (1.9) 0.5 (1.0) 6,373 (6,328)
80–84 6.7
85–89 4.8
90–94 2.6
95–99 1.5
≥100 0.5
14 Hypertension, dyslipidemia, urologic disease 31,911 (6.3) 75–79 5.7 6.6 (1.9) 3.9 (2.2) 0.5 (1.0) 6,519 (5,078)
80–84 7.3
85–89 7.0
90–94 5.4
95–99 3.4
≥100 1.9
15 Hypertension, dyslipidemia, hyperuricemia 31,777 (6.3) 75–79 6.6 6.2 (1.9) 3.3 (2.0) 0.5 (1.0) 5,696 (5,722)
80–84 6.7
85–89 5.3
90–94 4.0
95–99 2.0
≥100 1.5

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Figure 2.
The 15 most common 3-way chronic disease patterns among women aged 75 or older in Tokyo, Japan (n = 806,059) by rank and age group with average number of chronic diseases and annual number of outpatient facilities visited, hospital admissions, and outpatient medical expenditures. Percentages do not total 100 because of rounding. Source: Tokyo Extended Association of Medical Care System for the Latter-Stage Elderly People (14). Abbreviation: SD, standard deviation.

Rank 3-way patterns of chronic disease n (%) Age, y % Number of chronic diseases Mean (SD) Number of outpatient facilities visited Mean (SD) Number of admissions Mean (SD) Total outpatient medical expenditure (US$) Mean (SD)
1 Hypertension, Dyslipidemia, Peptic ulcer disease 102,907 (12.8) 75–79 12.5 6.0 (1.7) 3.8 (2.1) 0.4 (0.9) 5,871 (4,944)
80–84 14.9
85–89 13.1
90–94 8.9
95–99 5.2
≥100 2.6
2 Hypertension, Peptic ulcer disease, Osteoarthritis/Spine disorder 90,394 (11.2) 75–79 10.0 6.2 (1.7) 4.3 (2.2) 0.5 (1.0) 6,551 (5,342)
80–84 13.3
85–89 12.3
90–94 9.5
95–99 6.8
≥100 3.8
3 Hypertension, Dyslipidemia, Osteoarthritis/Spine disorder 85,869 (10.7) 75–79 10.9 6.0 (1.8) 4.2 (2.1) 0.4 (0.8) 5,848 (4,148)
80–84 12.6
85–89 10.2
90–94 6.1
95–99 3.4
≥100 1.2
4 Hypertension, Peptic ulcer disease, Coronary heart disease 81,226 (10.1) 75–79 7.8 6.3 (1.7) 3.8 (2.2) 0.6 (1.1) 6,462 (6,530)
80–84 11.3
85–89 12.7
90–94 12.1
95–99 9.9
≥100 6.7
5 Hypertension, Dyslipidemia, Coronary heart disease 78,426 (9.7) 75–79 8.9 6.1 (1.8) 3.7 (2.1) 0.4 (0.9) 5,627 (5,068)
80–84 11.2
85–89 11.0
90–94 8.0
95–99 5.1
≥100 2.4
6 Hypertension, Insomnia, Peptic ulcer disease 64,299 (8.0) 75–79 6.9 6.4 (1.7) 4.1 (2.3) 0.6 (1.0) 6,629 (6,021)
80–84 9.3
85–89 9.0
90–94 7.6
95–99 5.7
≥100 3.5
7 Hypertension, Peptic ulcer disease, Cerebrovascular accident 63,959 (7.9) 75–79 5.9 6.4 (1.8) 3.9 (2.2) 0.6 (1.0) 6,228 (5,518)
80–84 9.0
85–89 10.3
90–94 9.4
95–99 7.9
≥100 5.4
8 Dyslipidemia, Peptic ulcer disease, Osteoarthritis/Spine disorder 61,579 (7.6) 75–79 8.0 6.5 (1.7) 4.5 (2.3) 0.4 (0.9) 6,455 (4,639)
80–84 9.1
85–89 7.0
90–94 4.1
95–99 2.2
≥100 0.9
9 Hypertension, Osteoporosis, Osteoarthritis/Spine disorder 60,609 (7.5) 75–79 6.5 6.1 (1.8) 4.4 (2.2) 0.4 (0.8) 6,236 (4,387)
80–84 9.3
85–89 8.6
90–94 5.9
95–99 3.3
≥100 1.3
10 Hypertension, Insomnia, Dyslipidemia 60,545 (7.5) 75–79 7.5 6.2 (1.8) 4.0 (2.2) 0.4 (0.9) 5,729 (4,769)
80–84 8.9
85–89 7.4
90–94 4.7
95–99 2.6
≥100 1.3
11 Hypertension, Dyslipidemia, Cerebrovascular accident 60,292 (7.5) 75–79 6.6 6.2 (1.8) 3.8 (2.2) 0.4 (0.9) 5,572 (4,436)
80–84 8.8
85–89 8.6
90–94 6.1
95–99 4.1
≥100 1.8
12 Hypertension, Osteoporosis, Peptic ulcer disease 58,183 (7.2) 75–79 6.0 6.4 (1.7) 4.2 (2.2) 0.5 (0.9) 6,509 (4,829)
80–84 8.8
85–89 8.6
90–94 6.6
95–99 3.7
≥100 1.6
13 Hypertension, Osteoarthritis/Spine disorder, Coronary heart disease 57,035 (7.1) 75–79 5.7 6.5 (1.7) 4.3 (2.2) 0.5 (1.0) 6,542 (5,749)
80–84 8.3
85–89 8.6
90–94 7.1
95–99 5.6
≥100 3.1
14 Hypertension, Osteoporosis, Dyslipidemia 56,245 (7.0) 75–79 6.5 6.1 (1.8) 4.0 (2.1) 0.3 (0.8) 5,863 (3,904)
80–84 8.6
85–89 7.5
90–94 4.6
95–99 2.1
≥100 0.9
15 Dyslipidemia, Peptic ulcer disease, Coronary heart disease 56,085 (7.0) 75–79 6.4 6.5 (1.7) 3.9 (2.2) 0.5 (1.0) 6,296 (5,739)
80–84 8.1
85–89 7.7
90–94 5.6
95–99 3.1
≥100 1.7

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