Comorbidity and functional trajectories from midlife to old age: the Health and Retirement Study.

TitleComorbidity and functional trajectories from midlife to old age: the Health and Retirement Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsStenholm, S, Westerlund, H, Head, J, Hyde, M, Kawachi, I, Pentti, J, Kivimäki, M, Vahtera, J
JournalJ Gerontol A Biol Sci Med Sci
Date Published2015 Mar
ISSN Number1758-535X
KeywordsActivities of Daily Living, Age Factors, Aged, Aged, 80 and over, Chronic disease, Comorbidity, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Retirement, Socioeconomic factors, United States

BACKGROUND: The number of diseases and physical functioning difficulties tend to increase with age. The aim of this study was to examine the trajectories of physical functioning across age groups and whether the trajectories differ according to disease status in different population subgroups.

METHODS: Repeat data from a nationally representative population sample, the Health and Retirement Study, was used. Participants were 10,709 men and 13,477 women aged 60-107 years at baseline with biennial surveys from 1992 to 2010. Average length of follow-up was 10.3 years ranging from 0 to 18 years. Disease status and physical functioning was asked about at all study phases and 10 items were summed to obtain a physical functioning score (0-10).

RESULTS: Age modified the relationship between number of chronic diseases and physical functioning with older participants having more physical functioning difficulties with increasing number of diseases. An average 70-year-old participant with no diseases had 0.89 (95% CI: 0.85-0.93) physical functioning difficulties, with one disease 1.72 (95% CI: 1.69-1.76) difficulties, with two diseases 2.57 (95% CI: 2.52-2.62) difficulties, and with three or more diseases 3.82 (95% CI: 3.76-3.88) difficulties. Of the individual diseases memory-related diseases, stroke, pulmonary diseases, and arthritis were associated with significantly higher physical functioning difficulties compared with other diseases.

CONCLUSIONS: Comorbidity is associated with greater burden of physical functioning difficulties. Of the studied diseases, memory-related diseases, stroke, pulmonary diseases, and arthritis alone or in combination limit most physical functioning.

User Guide Notes

Endnote Keywords

Aging/Comorbidity/Physical functioning/Disability/Disability

Endnote ID


Alternate JournalJ. Gerontol. A Biol. Sci. Med. Sci.
Citation Key8241
PubMed ID25060316
PubMed Central IDPMC4336333
Grant ListMR/K013351/1 / / Medical Research Council / United Kingdom
AG034454 / AG / NIA NIH HHS / United States
HL36310 / HL / NHLBI NIH HHS / United States
K013351 / / Medical Research Council / United Kingdom