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Health behaviors and multimorbidity resilience among older adults using the Canadian Longitudinal Study on Aging

Published online by Cambridge University Press:  15 May 2019

Andrew Wister ,
Theodore Cosco ,
Barbara Mitchell  and
Ian Fyffe
Andrew Wister*
Affiliation:
Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
Theodore Cosco
Affiliation:
Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
Barbara Mitchell
Affiliation:
Departments of Gerontology and Sociology/Anthropology, Simon Fraser University, Vancouver, BC, Canada
Ian Fyffe
Affiliation:
Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
*
Correspondence should be addressed to: Andrew Wister, Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street Vancouver, BC V6B 5K3, Canada. Phone: (778) 7825044. Email: wister@sfu.ca.
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Abstract

Objective:

Recently, there has been a growing interest in examining forms of illness-related resilience. This study examines associations between lifestyle behavioral factors and multimorbidity resilience (MR) among older adults.

Methods:

Using baseline data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 6,771 Canadian adults aged 65 or older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: cardiovascular/metabolic, osteo-related, and mental health. Associations were explored using hierarchical linear regression modeling, controlling for sociodemographic, social/environmental, and illness context covariates.

Results:

Among older adults with two or more illnesses, as well as the cardiovascular/metabolic and osteo-related illness clusters, having a non-obese body mass, being a non-smoker, satisfaction with quality of sleep, having a good appetite, and not skipping meals are associated with MR. However, the mental-health cluster resulted in different behavioral lifestyle associations, where MR was not associated with obesity, smoking, or appetite, but inactivity demonstrated moderate positive associations with MR.

Discussion:

While there are similar patterns of lifestyle behaviors across multimorbidity and multimorbidity clusters involving physiological chronic illnesses, those associated with mental health are distinct. The results have implications for healthy aging among persons coping with multimorbidity.

Keywords

Aginghealthy agingresilience
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 1: Issue Theme: Cultural Diversity in Psychogeriatrics , January 2020 , pp. 119 - 133
Copyright
© International Psychogeriatric Association 2019 

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References

Agborsangaya, C. B., Lau, D., Lahtinen, M., Cooke, T. and Johnson, J. (2013a). Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Quality of Life Research, 22, 791–799. doi: 10.1007/s11136-012-0214-7.CrossRefGoogle ScholarPubMed
Agborsangaya, C. B., Ngwakongnwi, E., Lahtinen, M., Cooke, T. and Johnson, J. (2013b). Multimorbidity prevalence in the general population: the role of obesity in illness clustering. BMC Public Health, 13, 1161. doi: 10.1186/1471-2458-13-1161.CrossRefGoogle Scholar
Autenrieth, C. et al. (2013). Physical activity is inversely associated with multimorbidity in elderly men: results from the KORA-Age Augsburg Study. Preventive Medicine, 57, 17–19. doi: 10.1016/j.ypmed.2013.02.014.CrossRefGoogle ScholarPubMed
Cacioppo, J., Hawkley, L. and Thisted, R. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomology in the Chicago Health, Aging and Social Relations Study. Psychology and Aging, 25, 453–463. doi: 10.1037/a0017216.CrossRefGoogle Scholar
Canizares, M., Hogg-Johnson, M., Gignac, M., Glazier, R. and Badley, E. (2017). Increasing trajectories of multimorbidity over time: birth cohort differences and the role of changes in obesity and income. Journal of Gerontology, 00, 1–12. doi: 10.1093/geronb/gbx004.Google Scholar
Connelly, E., Allen, C., Hatfield, K., Palma-Oliveira, J., Woods, D. and Linkov, I. (2017). Features of resilience. Environmental Systems and Decisions, 37, 46–50.CrossRefGoogle Scholar
Cornell, J., Pugh, J. and Williams, J. W. (2007). Multimorbidity clusters: clustering binary data from multimorbidity clusters; clustering binary data from a large administrative medical database. Journal of General Internal Medicine, 22, 419–424.Google Scholar
Cornwell, E. Y. and Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behaviour 50, 31–48.CrossRefGoogle ScholarPubMed
Cosco, T., Kaushal, A., Hardy, R., Richards, M., Kuh, D. and Stafford, M. (2017). Operationalising resilience in longitudinal studies: a systematic review of methodological approaches. Journal of Epidemiology and Community Health, 77, 98–104.CrossRefGoogle Scholar
Cosco, T., Stephan, B. and Brayne, C. (2015). Validation of an a priori, index model of successful aging in a population-based cohort study: the successful aging index. International Psychogeriatrics, 27, 1971–1977. doi: 10.1017/S1041610215000708.CrossRefGoogle Scholar
Cosco, T. D., Wister, A., Brayne, C. and Howse, K. (2018). Psychosocial aspects of successful ageing and resilience: critique, integration and implications. Estudios de Psicología, 39, 248–266. doi: 10.1080/02109395CrossRefGoogle Scholar
Diener, E., Emmons, R. A., Larsen, R. J. and Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75. doi: 10.1207/s15327752jpa4901_13.CrossRefGoogle ScholarPubMed
Ezeamama, A., Elkins, J., Simpson, C., Smith, S., Allegra, J. and Miles, T. (2016). Indicators of resilience and healthcare outcomes: findings from the 2010 health and retirement survey. Quality of Life Research, 25, 1007–1015. doi 10.1007/s11136-015-1144-y.CrossRefGoogle ScholarPubMed
Fillenbaum, G. G. and Smyer, M. A. (1981). The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of Gerontology, 36, 428–434. doi: 10.1093/geronj/36.4.428.CrossRefGoogle ScholarPubMed
Freund, T., Kuna, C. U., Ose, D., Szecsenyi, J. and Peters-Klimm, F. (2012). Patterns of multimorbidity in primary care patients at high risk of future hospitalization. Population Health Management, 15, 1–6.CrossRefGoogle ScholarPubMed
Galenkamp, H., Braam, A., Huisman, M. and Deeg, D. (2011). Somatic multimorbidity and self-rated health in the older population. Journal of Gerontology, 66B, 380–386. doi: 10.1093/geronb/gbr032.CrossRefGoogle Scholar
Guralnik, J. et al. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, 85–94. doi: 10.1093/geronj/49.2.M85.CrossRefGoogle Scholar
Holden, L., Scuffdham, P. A., Hilton, M. F., Muspratt, A., Ng, S. K. and Whiteford, H. A. (2011). Patterns of multimorbidity in working Australians. Population Health Metrics, 9, 15.CrossRefGoogle ScholarPubMed
Islam, M., Valderas, J., Yen, L., Dawda, P., Jowsey, T. and McRae, I. S. (2014). Multimorbidity and comorbidity of chronic diseases among the senior Australians: prevalence and patterns. PLoS ONE, 9, e83783. doi: 10.1371/journal.pone.0083783.CrossRefGoogle ScholarPubMed
Kendig, H., Browning, C., Thomas, S. and Wells, Y. (2014). Health, lifestyle and gender influences on aging well: an Australian longitudinal analysis to guide health promotion. Frontiers in Public Health, 2, 70. doi: 10.3389/fpubh.2014.00070.CrossRefGoogle ScholarPubMed
Kessler, R. et al. (2002). Short screening scales to monitor population differences and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976. doi: 10.1017/S0033291702006074.CrossRefGoogle Scholar
Kirchberger, I. et al. (2012). Patterns of multimorbidity in the aged population. Results from the KORA-Age study. PLoS ONE, 7, e30556.CrossRefGoogle ScholarPubMed
McCrory, C. et al. (2016). Social disadvantage and social isolation are associated with a higher resting heart rate: evidence from the Irish longitudinal study on ageing. Journal of Gerontology, 71, 463–473. doi: 10.1093/geronb/gbu163.CrossRefGoogle ScholarPubMed
National Institute on Alcohol Abuse and Alcoholism. (2015). Dietary Guidelines for Americans 2015–2020. U.S. Department of Health and Human Services and U.S. Department of Agriculture. Retrieved from https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/.Google Scholar
Ng, S. K., Holden, L. and Sun, J. (2012). Identifying comorbidity patterns of health conditions via cluster analysis of pairwise concordance statistics. Statistics in Medicine, 31, 3393–3405. doi: 10.1002/sim.5426.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Schieman, S., Fazio, E. M. and Meersman, S. (2005). Stress, health, and the life course: some conceptual perspectives. Journal of Health and Social Behavior, 46, 205–219. doi: 10.1177/002214650504600206.CrossRefGoogle ScholarPubMed
Peters, S., Cosco, T., Mackey, D., Sarohia, G., Leong, J. and Wister, A. (2019). Methods for quantifying physical resilience in aging: a scoping systematic review protocol. Systematic Reviews, 8, 34–40. doi: 10.1186/s13643-019-0950-7.CrossRefGoogle Scholar
Prados-Torres, A. et al. (2012). Multimorbidity patterns in primary care: interactions among chronic diseases using factor analysis. PLoS ONE, 7, e32190.CrossRefGoogle ScholarPubMed
Pruchno, R. and Wilson-Genderson, M. (2012). Adherence to clusters of health behaviors and successful aging. Journal of Aging and Health, 24, 1279–1297. doi: 10.1177/0898264312457412.CrossRefGoogle ScholarPubMed
Pruchno, R. and Carr, D. (2017). Successful aging 2.0: resilience and beyond, Journals of Gerontology: Series B, 72, 201–203. doi: 10.1093/geronb/gbw214.CrossRefGoogle ScholarPubMed
Quiñones, A. R., Liang, J., Bennett, J. M., Xu, X. and Ye, W. (2011). How does the trajectory of multimorbidity vary across Black, White, and Mexican Americans in middle and old age? Journal of Gerontology, 66, 739–749. doi: 10.1093/geronb/gbr106.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi: 10.1177/014662167700100306.CrossRefGoogle Scholar
Raina, P. et al. (2009). The Canadian longitudinal study of aging. Canadian Journal of Aging, 28, 221–230.CrossRefGoogle Scholar
Rybarczyk, B., Emery, E., Guequierre, L., Shamaskin, A. and Behel, J. (2012). The role of resilience in chronic illness and disability in older adults. In Hayslip, B. and Smith, G. (Eds.) Annual Review of Gerontology and Geriatrics, Volume 32, 2012, Special Issue: Emerging Perspectives on Resilience in Adulthood and Later Life (pp. 173–188). New York: Springer.Google Scholar
Salive, M. (2013). Multimorbidity in older adults. Epidemiologic Reviews, 35, 75–83. doi: 10.1093/epirev/mxs009.CrossRefGoogle ScholarPubMed
Schafer, I. et al. (2010). Multimorbidity patterns in the elderly: a new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS ONE, 5, e15941.CrossRefGoogle ScholarPubMed
Searle, S., Mitnitski, A. Gahbauer, E. Gill, T. and Rockwood, K. (2008). A standard procedure for creating a frailty index. Biomedical Central Geriatrics, 8, 24. doi: 10.1186/1471-2318-8-24.Google ScholarPubMed
Sells, D. et al. (2009). Cascading crises, resilience, and social support within the onset and development of multiple chronic conditions. Chronic Illness, 5, 92–102. doi: 10.1177/1742395309104166.CrossRefGoogle ScholarPubMed
Sharkey, J. (2003). Risk and presence of food insufficiency are associated with low nutrient intakes and multimorbidity among homebound older women who receive home-delivered meals. The Journal of Nutrition, 133, 3485–3491.CrossRefGoogle ScholarPubMed
Sherbourne, C. D. and Stewart, A. L. (1991). The MOS social support survey. Social Science & Medicine, 32, 705–714. doi: 10.1016/0277-9536(91)90150-B.CrossRefGoogle ScholarPubMed
Silverman, A., Molton, I., Alschuler, K., Ehde, D. and Jensen, M. (2015). Resilience predicts functional outcomes in people aging with disabilities: a longitudinal investigation. Archives of Physical Medicine and Rehabilitation, 96, 1262–1268.CrossRefGoogle Scholar
Skivington, K., Katikireddi, S., Leyland, A., Hunt, K. and Mercer, S. (2015). Risk factors for multimorbidity: a multilevel analysis of a longitudinal cohort from Scotland. European Journal of Public Health, 25, 1 October 2015, ckv167.020. doi: 10.1093/eurpub/ckv167.020CrossRefGoogle Scholar
Smith, K. W. (1991). PASE Journal of Gerontology Administration and Scoring Instruction Manual. Watertown, MA: New England Research Institutes.Google Scholar
Stewart, D. and Yuen, T. (2011). A systematic review of resilience in the physically ill. Psychosomatics, 52, 199–209.CrossRefGoogle ScholarPubMed
Trivedi, R., Bosworth, H. and Jackson, G. (2011). Resilience in chronic illness. In Resnick, B., Gwyther, L. and Roberto, K. (Eds.) Resilience in Aging: Concepts, Research and Outcomes (pp. 45–63) New York, NY: Springer.Google Scholar
Ungar, M. (2011). The social ecology of resilience: addressing contextual and cultural ambiguity of a nascent construct. American Journal of Orthopsychiatry, 81, 1–17.CrossRefGoogle ScholarPubMed
Whitson, H. et al. (2016). Identifying patterns of multimorbidity in older Americans: applications of latent class analysis. American Geriatrics Society, 64, 1668–1673.CrossRefGoogle Scholar
Wiles, J., Wild, K., Kerse, N. and Allen, R. (2012). Resilience from the point of view of older people: ‘There’s still life beyond the funny knee’. Social Science and Medicine, 74, 416–424.CrossRefGoogle ScholarPubMed
Windle, G. (2011). What is resilience? A review and concept analysis. Reviews in Clinical Gerontology, 21, 152–169. doi: 10.1017/S0959259810000420CrossRefGoogle Scholar
Windle, G. (2012). The contribution of resilience to healthy ageing. Perspectives in Public Health, 132, 159–160. doi: 10.1177/1757913912449572.Google ScholarPubMed
Wister, A. (2005). Baby Boomer Health Dynamics: How Are We Aging? Toronto, ON: University of Toronto Press.CrossRefGoogle Scholar
Wister, A., Levasseur, M., Griffiths, L. and Fyffe, I. (2015). Estimating multiple morbidity disease burden among older persons: a convergent construct validity study to discriminate between six chronic illness measures, CCHS 2008/09. Biomedical Central Geriatrics, 15, 12. doi: 10.1186/s12877-015-0001-8.Google ScholarPubMed
Wister, A., Kendig, H., Mitchell, B. A., Fyffe, I. and Loh, V. (2016a). Multimorbidity, health and aging in Canada and Australia: a tale of two countries. Biomedical Central Geriatrics, 16, doi: 10.1186/s12877-016-0341-z.Google ScholarPubMed
Wister, A., Coatta, K., Schuurman, N., Lear, S., Rosin, M. and MacKey, D. (2016b). A lifecourse model of resilience applied to aging with multimorbidity. International Journal of Aging & Human Development, 82, 290–313. doi: 10.1177/0091415016641686.CrossRefGoogle ScholarPubMed
Wister, A. et al. (2018). Development and validation of a multi-domain multimorbidity resilience index for an older population: results from the baseline Canadian longitudinal study on aging. Biomedical Central (BMC) Geriatrics, 18, 170. doi: 10.1186/s12877-018-0851-y.Google ScholarPubMed
Wister, A. V. (2019). Aging as a Social Process: Canada and Beyond, 7th Edition. Don Mills, ON: Oxford University Press.Google Scholar