Nondisease-Specific Problems and All-Cause Mortality in the REasons for Geographic and Racial Differences in Stroke Study

• Autores: C. Barrett Bowling, John N. Booth III, Monika M. Safford, Heather E. Whitson, Christine S. Ritchie, Virginia G. Wadley, Mary Cushman, Virginia J. Howard, Richard M. Allman, Paul Muntner
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 5, 2013, págs. 739-746
• Idioma: inglés
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• Resumen

  • Objectives: To evaluate the association between six nondisease-specific problems (problems that cross multiple domains of health) and mortality in middle-aged and older adults.

    Design: Prospective, observational cohort.

    Setting: U.S. population sample.

    Participants: Participants included 23,669 black and white U.S. adults aged 45 and older enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.

    Measurements: Nondisease-specific problems included cognitive impairment, depressive symptoms, exhaustion, falls, impaired mobility, and polypharmacy. Age-stratified (<65, 65�74, ?75) hazard ratios for all-cause mortality were calculated for each problem individually and according to number of problems.

    Results: One or more nondisease-specific problems occurred in 40% of participants younger than 65, 45% of those aged 65 to 74, and 55% of those aged 75 and older. Compared with participants with none of these problems, the multivariable adjusted hazard ratio for all-cause mortality associated with each additional nondisease-specific problem was 1.34 (95% confidence interval (CI) = 1.23�1.46) for participants younger than 65, 1.24 (95% CI = 1.15�1.35) for those aged 65 to 74, and 1.30 (95% CI = 1.21�1.39) for those aged 75 and older.

    Conclusion: Nondisease-specific problems were associated with mortality across a wide age spectrum. Future studies should explore whether treating these problems will improve survival and identify innovative healthcare models to address multiple nondisease-specific problems simultaneously.