Human Development and Family Sciences, Texas State University, San Marcos, Texas, USA.
Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA.
J Gerontol B Psychol Sci Soc Sci. 2022 Oct 6;77(10):1867-1879. doi: 10.1093/geronb/gbac070.
Multimorbidity, also referred to as multiple chronic conditions (MCCs), is the concurrent presence of 2 or more chronic health conditions. Increasing multimorbidity represents a substantial threat to the health of aging populations. Recent trends suggest greater risk of poor health and mortality among later-born cohorts, yet we are unaware of work examining cohort differences in multimorbidity among aging U.S. adults.
We examine intercohort variation in MCC burden in adults aged 51 years and older using 20 years (n = 33,598; 1998-2018) of repeated assessment drawn from the Health and Retirement Study. The index of MCCs included 9 chronic conditions (heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer excluding skin cancer, high depressive symptoms, and cognitive impairment). We used linear mixed models with various approaches to estimate age/period/cohort effects to model intercohort patterns in MCC burden. We also explored variation in the specific conditions driving cohort differences in multimorbidity.
More recent cohorts had greater MCC burden and developed multimorbidity at earlier ages than those born to prior generations. The burden of chronic conditions was patterned by life-course sociodemographic factors and childhood health for all cohorts. Among adults with multimorbidity, arthritis and hypertension were the most prevalent conditions for all cohorts, and there was evidence that high depressive symptoms and diabetes contributed to the observed cohort differences in multimorbidity risk.
Our results suggest increasing multimorbidity burden among more recently born cohorts of aging U.S. adults and should inform policy to address diminishing health in aging populations.
多种并存疾病（multimorbidity），也被称为多种慢性疾病（multiple chronic conditions，MCCs），是指同时存在两种或多种慢性健康问题。多种并存疾病的发病率不断上升，对老年人口的健康构成了重大威胁。最近的趋势表明，出生较晚的人群健康状况较差和死亡率较高的风险更大，但我们还没有研究工作检查美国老年成年人中多种并存疾病的队列差异。
我们使用来自健康与退休研究（Health and Retirement Study）的 20 年（n=33598；1998-2018 年）重复评估数据，研究 51 岁及以上成年人的 MCC 负担在不同队列之间的变化。MCC 指数包括 9 种慢性疾病（心脏病、高血压、中风、糖尿病、关节炎、肺部疾病、癌症除外皮肤癌、高抑郁症状和认知障碍）。我们使用线性混合模型和各种方法来估计年龄/时期/队列效应，以模型化 MCC 负担的队列间模式。我们还探索了导致多种并存疾病队列差异的具体条件的变化。
较新的队列比前几代人的 MCC 负担更大，并且在更早的年龄就出现了多种并存疾病。所有队列的慢性疾病负担都受到生命历程社会人口因素和儿童健康的影响。在患有多种并存疾病的成年人中，关节炎和高血压是所有队列中最常见的疾病，有证据表明，高抑郁症状和糖尿病导致了观察到的多种并存疾病风险的队列差异。
我们的研究结果表明，美国老年成年人中较新出生队列的多种并存疾病负担不断增加，应该为解决老年人口健康状况恶化的问题提供政策信息。
