Many Older Adults Have Both Chronic Illnesses and "Geriatric Syndromes"
Monday, March 2, 2009
Chronic diseases such as such as heart disease and diabetes are common among older adults. In fact, many older adults have more than one chronic disease -- in other words, chronic diseases often "co-occur" in older people. About 65% of Medicare beneficiaries have two or more chronic diseases and 43% have three or more.
Older adults with multiple chronic illnesses report having poorer heath and more difficulty functioning than older people with just one chronic disease. They also need more healthcare services, and are likely to die earlier than older people with just one chronic disease.
Like chronic diseases, "geriatric syndromes" are very common among older adults. Delirium (a kind of temporary confusion) and dementia (an illness, such as Alzheimer's disease, characterized by ongoing confusion and memory loss) are examples of geriatric syndromes. Urinary incontinence (or bladder problems), dizziness, a tendency to fall, and vision and hearing problems are other geriatric syndromes. Geriatric syndromes usually have more than one cause, and involve several different body systems. In addition, one geriatric syndrome often contributes to another. Urinary incontinence, for example, may lead to a bladder infection, which may, in turn, cause delirium. Like chronic diseases, geriatric syndromes can limit older adults' abilities to function, and result in their needing a lot of healthcare services.
New Research in the Journal of the American Geriatrics Society
To find out whether chronic diseases and geriatric syndromes often "co-occur" in older adults - just as chronic diseases do - researchers recently studied information from a large nationwide study. The study included more than 11,000 adults who were 65 or older.
The researchers checked to see how many of the adults had at least one of five conditions. The five included three chronic diseases (heart disease, congestive heart failure, and diabetes) and two geriatric syndromes (urinary incontinence and recurring falls).
The researchers found that 56% of the adults had at least one of the conditions. They also found that more than 25% of the older adults who had at least one of the chronic diseases also had at least one of the geriatric syndromes.
A "substantial proportion of older adults have geriatric syndromes co-occurring with their chronic diseases," the researchers report in The Journal of the American Geriatrics Society. "Thus, physicians should address older adult patients' geriatric syndromes as well as their chronic diseases."
Because many older adults appear to have both chronic illnesses and geriatric syndromes, medical researchers should develop care guidelines for and ways of measuring the quality of care of adults with both chronic illnesses and geriatric syndromes, they researchers add.
In addition, researchers should investigate whether the same things that appear to cause chronic illnesses may also cause geriatric syndromes. This research could lead to new ways to prevent, recognize and manage co-occurring chronic conditions and geriatric syndromes in a coordinated and comprehensive way, rather than focus on these health problems individually, they write.
The "results from our study suggest that as increased numbers of older adult patients present with multiple co-occurring diseases and geriatric syndromes, physicians will be required to provide comprehensive care," they conclude.
The summary above is from the full report titled, "The Co-occurrence of Chronic Diseases and Geriatric Syndromes: The Health and Retirement Study." It is in the March 2009 issue of the Journal of the American Geriatrics Society (Volume 57, Issue 3). The report is authored by Pearl G. Lee, MD, Christine Cigolle, MD, MPH, and Caroline Blaum, MD, MS.