Delligatti, Amanda
(2018)
Multimorbidity and functional capacity in geriatric patients with cardiovascular disease.
Master Essay, University of Pittsburgh.
Abstract
Introduction: With the aging population and average increase of global life expectancy, individuals are more commonly experiencing chronic disease in the context of multiple comorbidities. In US adults age 65 and older, multimorbidity has become more common than any one condition alone and its prevalence increases rapidly with age. Individuals with cardiovascular disease (CVD) experience significant multimorbidity burden, including both concordant cardiovascular comorbidities and discordant non-cardiac comorbidities. More research is needed to understand how discordant multimorbidity affects the functional capacity and overall quality of life in patients with CVD to characterize the healthcare challenges that these individuals experience.
Objectives: The primary aims of this study were to assess prevalence of discordant multimorbidity in geriatric patients with CVD, and to investigate associations between discordant multimorbidity and functional capacity.
Study Design: Cross-sectional analysis of a sample of 350 Veterans age 65+ with CVD who participated in a baseline evaluation of physical function at the VA Pittsburgh Cardiac Rehabilitation program between July 2015 and April 2018.
Methods: Descriptive statistics were produced using t-tests for continuous measures and chi-square analysis for categorical response variables. Multiple linear regression models were used to assess the associations between discordant multimorbidity, functional status, and universal mental health outcomes based on physical evaluations and quality of life questionnaires.
Results: Prevalence of discordant multimorbidity was 89.14%. When assessing the number of discordant comorbidities as a categorical predictor, each additional comorbidity was significantly associated with poorer performance in all six tested physical and mental function outcomes. When stratified by multimorbidity groups compared to those with CVD-only, patients with only 1 discordant comorbidity did not differ significantly in functional capacity, but those with 2-3 comorbidities had generally lower function and those with ≥4 comorbidities had the poorest mental and physical function outcomes.
Conclusion: This study suggests that among adults age 65+ with CVD, an increasing number of multiple discordant chronic conditions is associated with a higher risk of decreased functional capacity and self-rated quality of life. These results from a defined cohort of geriatric patients provide important insight on population patterns regarding the emerging public health issue of multimorbidity.
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| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Committee Chair | Kuipers, Allison | kuipersa@edc.pitt.edu | kuipersa | UNSPECIFIED | | Committee Member | Forman, Daniel | formand@pitt.edu | formand | UNSPECIFIED | | Committee Member | Althouse, Andrew | althousead@upmc.edu | althousead | UNSPECIFIED |
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| Date: |
27 April 2018 |
| Date Type: |
Submission |
| Number of Pages: |
50 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Date Deposited: |
31 May 2019 14:55 |
| Last Modified: |
31 May 2019 15:05 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/34154 |
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