The Prevalence of Multimorbidity Among Adults Aged 65 Years and Older in the United States, Differences by Race/Ethnicity Restricted; Files Only

Abstract

Objective

The population of older adults in the U.S. is increasing, and the prevalence of multimorbidity has been consistently high across studies, where multimorbidity is defined as the coexistence of two or more chronic conditions in an individual. However, little is known about the prevalence of multimorbidity in older adults of different racial groups. This study aimed to assess the prevalence of multimorbidity involving seven chronic conditions among U.S. adults aged 65 years and older by race/ethnicity.

Methods

           Data was analyzed on 8992 adults aged 65 years and older in the U.S. from the Health Retirement Study (HRS) in 2018, a nationally representative study of U.S. older adults. Seven self-reported chronic conditions were used to assess multimorbidity in this study: hypertension, diabetes, cancer, lung disease, heart problems, stroke, and arthritis. Descriptive analyses were used to show differences in multimorbidity prevalence across selected sociodemographic variables. Polytomous logistic regression models were performed to evaluate the association between multimorbidity with race/ethnicity and covariates (age, gender, education level, marital status, and total household income). All the analyses were adjusted by survey weights, aiming to generate nationally represented estimates.

Results

           73.4% of older adults aged 65 years and over in the U.S. had multimorbidity. A higher prevalence of multimorbidity is associated with individuals with a non-Hispanic Black background, female, having a lower household income, attaining lower levels of education, or being divorced, unmarried, or widowed. Non-Hispanic Blacks had higher odds of having multimorbidity compared to non-Hispanic Whites; Hispanics were more likely to experience three or more chronic conditions compared to non-Hispanic Whites. Hypertension-arthritis was the most prevalent dyad across all racial groups; triads including hypertension were common across all racial/ethnic groups.

Conclusions

           There was a significant association between non-Hispanic Blacks and multimorbidity. No significant association was found between Hispanic or non-Hispanic Others and multimorbidity. The chronic conditions patterns (dyads and triads) were similar across racial people, except non-Hispanic Whites.

Table of Contents

Table of Contents

I. INTRODUCTION

Objective and Research Question

II. LITERATURE REVIEW

Multimorbidity Definitions

Multimorbidity Patterns

Prevalence of Multimorbidity in the United States

Overall Prevalence of Multimorbidity in United States

Prevalence of Multimorbidity by Demographic Groups

Risk Factors of Multimorbidity

Multimorbidity in Elderly People

Missing in Existing Literature

Conceptual Framework

Study Significance

Factors Associated with Multimorbidity

The Transition from Chronic Condition to Multimorbidity

Study Variable Selection

Representation of Conceptual Framework

III. METHODS

Data Source

Variables

Independent Variable of Interest

Other Independent Variables

Dependent Variables

Data Preparation

Sample Creation

Data Filtering and Variable Selection

Data Cleaning and Coding

Creation of Chronic Diseases Combinations

Statistical Analyses

Descriptive Analyses

Modelling

IV. RESULTS

Descriptive Statistics Results

Univariate Analyses

Prevalence of Chronic Conditions

Prevalence of Individual Chronic Conditions

Chronic Conditions Combination: Dyads and Triads

Polytomous Logistic Regression

One Chronic Condition

Multimorbidity: Two Chronic Conditions

Multimorbidity: Three and More Chronic Conditions

V.DISCUSSION

Strength and Limitations

Conclusion

VI.REFERENCES

VII.TABLES AND FIGURES

Table 1. Sample Characteristics of Adults aged 65+ in the US

Table 2. Prevalence of Number of Chronic Diseases* Among U.S Adults aged 65+ by Race/Ethnicity Groups

Table 3. Prevalence of Chronic Disease by Race/Ethnicity among U.S Adults aged 65+

Table 4: Most Prevalent Dyads of Chronic Diseases among U.S Adults with Two Chronic Conditions, by Race and Ethnicity

Table 5. Most Prevalent Triads of Chronic Diseases among U.S Adults with Three Chronic Conditions, by Race and Ethnicity

Table 6. Results of the Polytomous Logistic Regression Analysis

Figure 1. Most Prevalent Dyads of Chronic Diseases among U.S Adults with Two Chronic Conditions, by Race and Ethnicity

Figure 2. Most Prevalent Triads of Chronic Diseases among U.S Adults with Three Chronic Conditions, by Race and Ethnicity

VIII. APPENDICES

Table 1. Sample Characteristics of Adults aged 65+ in the U.S (n=8992)

Table 2. Prevalence of Chronic Condition Dyads Among U.S. Adults Aged 65+ with Two Chronic Conditions

Table 3. Prevalence of Chronic Condition Triads Among U.S. Adults Aged 65+ with Three Chronic Conditions

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Aging
Keyword	Older Adults Multimorbidity Race/Ethnicity
Committee Chair / Thesis Advisor	SOLVEIG A. CUNINGHAM, Emory University

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