Exploring the complexity, management and health-related outcomes of disability, frailty and multimorbidity among community-dwelling older adults in Canada

The lifespan of Canadians is increasing because of improvements in clinical medicine and public health interventions. While an important achievement, living longer is not synonymous with good health. This results in life years that are deprived of full health due to disease and/or deficits, including living with disability, frailty and multiple chronic diseases. This also results in increased health care costs and decreased quality of life for an ageing population. The purposes of this research are to identify the frequency, management and health outcomes of living with disability, frailty and multimorbidity among community-dwelling older adults. This research will examine the degree of overlap between these three interrelated, but different concepts in ageing, and how this relates to management of these health states and health-related outcomes. These relationships will be assessed by age and sex, as well as by adjusting for sociodemographic information, geographic location, health behaviours, social environment.

Overall, the prevalence of two or more conditions was 50.0% and the prevalence of three or more conditions was 27.3%. The majority of participants (both females and males) living with multimorbidity had multiple conditions diagnosed after the age of 45 years. In the adjusted multivariable regression analyses, specific patterns could be identified for participants diagnosed with early multimorbidity, as well as both early and late multimorbidity, particularly among participants under the age of 75 years. More specifically, participants with early multimorbidity or both early and late multimorbidity had increased odds of physical disability, social limitation, increased frailty level and more negative perceived general and mental health. These patterns were detected for both two or more and three or more conditions, indicating the potentially important impact of the age of onset of multimorbidity.