dc.contributor.author |
Teh, Ruth |
en |
dc.contributor.author |
Menzies, Oliver H |
en |
dc.contributor.author |
Connolly, Martin |
en |
dc.contributor.author |
Doughty, Robert |
en |
dc.contributor.author |
Wilkinson, Tim J |
en |
dc.contributor.author |
Pillai, Avineshwaran |
en |
dc.contributor.author |
Lumley, Thomas |
en |
dc.contributor.author |
Ryan, Cristin |
en |
dc.contributor.author |
Rolleston, Anna |
en |
dc.contributor.author |
Broad, Joanna |
en |
dc.contributor.author |
Kerse, Ngaire |
en |
dc.date.accessioned |
2018-10-19T02:35:52Z |
en |
dc.date.issued |
2018-03 |
en |
dc.identifier.issn |
0002-0729 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/42979 |
en |
dc.description.abstract |
Background:multi-morbidity is associated with poor outcomes and increased healthcare utilisation. We aim to identify multi-morbidity patterns and associations with potentially inappropriate prescribing (PIP), subsequent hospitalisation and mortality in octogenarians. Methods:life and Living in Advanced Age; a Cohort Study in New Zealand (LiLACS NZ) examined health outcomes of 421 Māori (indigenous to New Zealand), aged 80-90 and 516 non-Māori, aged 85 years in 2010. Presence of 14 chronic conditions was ascertained from self-report, general practice and hospitalisation records and physical assessments. Agglomerative hierarchical cluster analysis identified clusters of participants with co-existing conditions. Multivariate regression models examined the associations between clusters and PIP, 48-month hospitalisations and mortality. Results:six clusters were identified for Māori and non-Māori, respectively. The associations between clusters and outcomes differed between Māori and non-Māori. In Māori, those in the complex multi-morbidity cluster had the highest prevalence of inappropriately prescribed medications and in cluster 'diabetes' (20% of sample) had higher risk of hospitalisation and mortality at 48-month follow-up. In non-Māori, those in the 'depression-arthritis' (17% of the sample) cluster had both highest prevalence of inappropriate medications and risk of hospitalisation and mortality. Conclusions:in octogenarians, hospitalisation and mortality are better predicted by profiles of clusters of conditions rather than the presence or absence of a specific condition. Further research is required to determine if the cluster approach can be used to target patients to optimise resource allocation and improve outcomes. |
en |
dc.format.medium |
Print |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
Age and ageing |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.subject |
Humans |
en |
dc.subject |
Prognosis |
en |
dc.subject |
Polypharmacy |
en |
dc.subject |
Hospitalization |
en |
dc.subject |
Geriatric Assessment |
en |
dc.subject |
Cause of Death |
en |
dc.subject |
Risk Assessment |
en |
dc.subject |
Risk Factors |
en |
dc.subject |
Age Factors |
en |
dc.subject |
Aging |
en |
dc.subject |
Time Factors |
en |
dc.subject |
Aged, 80 and over |
en |
dc.subject |
Oceanic Ancestry Group |
en |
dc.subject |
New Zealand |
en |
dc.subject |
Female |
en |
dc.subject |
Male |
en |
dc.subject |
Inappropriate Prescribing |
en |
dc.subject |
Potentially Inappropriate Medication List |
en |
dc.subject |
Multimorbidity |
en |
dc.title |
Patterns of multi-morbidity and prediction of hospitalisation and all-cause mortality in advanced age. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1093/ageing/afx184 |
en |
pubs.issue |
2 |
en |
pubs.begin-page |
261 |
en |
pubs.volume |
47 |
en |
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
29281041 |
en |
pubs.end-page |
268 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
720222 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
Population Health |
en |
pubs.org-id |
Gen.Practice& Primary Hlthcare |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Medicine Department |
en |
pubs.org-id |
Science |
en |
pubs.org-id |
Statistics |
en |
dc.identifier.eissn |
1468-2834 |
en |
pubs.record-created-at-source-date |
2017-12-28 |
en |
pubs.dimensions-id |
29281041 |
en |