Publication date: January–February 2020
Source: Archives of Gerontology and Geriatrics, Volume 86
Author(s): Helle Gybel Juul-Larsen, Ove Andersen, Thomas Bandholm, Ann Christine Bodilsen, Thomas Kallemose, Lillian Mørch Jørgensen, Henrik Hedegaard Klausen, Hanne Gilkes, Janne Petersen
Abstract
Introduction
Multimorbidity is common among older people and may contribute to adverse health effects, such as functional limitations. It may help stratify rehabilitation of older medical patients, if we can identify differences in function under and after an acute medical admission, among patient with different patterns of multimorbidity.
Aim
To investigate differences in function and recovery profiles among older medical patients with different patterns of multimorbidity the first year after an acute admission.
Methods
Longitudinal prospective cohort study of 369 medical patients (77.9 years, 62% women) acutely admitted to the Emergency Department. During the first 24 h after admission, one month and one year after discharge we assessed mobility level using the de Morton Mobility Index. At baseline and one-year we assessed handgrip strength, gait speed, Barthel20, and the New Mobility Score. Information about chronic conditions was collected by national registers. We used Latent Class Analysis to determine differences among patterns of multimorbidity based on 22 chronic conditions.
Results
Four distinct patterns of multimorbidity were identified (Minimal chronic disease; Degenerative, lifestyle, and mental disorders; Neurological, functional and sensory disorders; and Metabolic, pulmonary and cardiovascular disorders). The “Neurological, functional and sensory disorders”-pattern showed significant lower function than the “Minimal chronic disease”-pattern in all outcome measures. There were no differences in recovery profile between patients in the four patterns.
Conclusion
The results support that patients with different patterns of multimorbidity among acutely hospitalized older medical patients differ in function, which suggests a differentiated approach towards treatment and rehabilitation warrants further studies.