Multi-morbidity in Older Adults

with AF
Michael A. Chen
Clin Geriatr Med 32 (2016) 315–329
• Multimorbidity” is defined as being present when
a patient has at least 2 chronic medical or
psychiatric conditions that may or may not
interact.
• “Comorbidity” is defined as one or more
conditions that coexist in the context of a primary
disease.
• Multimorbidity is present in more than two-thirds
of Medicare beneficiaries over the age of 65, with
about one-third having 4 or more conditions.
• Approximately 83% of those 85 years and older
have 2 or more chronic conditions.
• The most common comorbidities in younger patients (defined as being <65 years
of age) were hypertension (57%), diabetes mellitus
• (23%), obesity (21%), chronic obstructive pulmonary disease (COPD; 17%), and
• alcohol abuse (8%), whereas for older patients (those 65 years), the most common
• comorbidities were hypertension (70%), diabetes mellitus (25%), COPD (23%),
• chronic kidney disease (14%), and obesity (8%). Notable differences were that
• younger patients had higher rates of obesity and alcohol use, whereas older
patients
• were more likely to have kidney disease. There was also a longer average length of
• stay (3.7 vs 2.9 days; P<.001) and higher in-hospital mortality (1% vs 0.3%; P<.001)
• for older vs younger patients.