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

  • Author(s): Bowling, CB
  • Booth, JN
  • Safford, MM
  • Whitson, HE
  • Ritchie, CS
  • Wadley, VG
  • Cushman, M
  • Howard, VJ
  • Allman, RM
  • Muntner, P
  • et al.

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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. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

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