Nondisease-specific problems and all-cause mortality in the REasons for Geographic and Racial Differences in Stroke study

J Am Geriatr Soc. 2013 May;61(5):739-46. doi: 10.1111/jgs.12214. Epub 2013 Apr 25.

Abstract

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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans*
  • Age Distribution
  • Aged
  • Cause of Death / trends
  • Comorbidity
  • European Continental Ancestry Group*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Population Surveillance*
  • Psychotic Disorders / complications
  • Psychotic Disorders / etiology*
  • Psychotic Disorders / mortality
  • Risk Assessment / methods*
  • Risk Factors
  • Sex Distribution
  • Stroke / complications
  • Stroke / ethnology*
  • Stroke / mortality
  • Survival Rate / trends
  • United States / epidemiology