Multiple Comorbidities: Does Age Matter?

New research creates a younger image of patients with multiple comorbid conditions.


The stereotype of someone with multiple comorbid conditions (MCCs) is an older, often overweight person. But according to an analysis of data from > 200,000 respondents in the 2015 Behavioral Risk Factor Surveillance System (BRFSS), people aged < 65 years are more likely to report MCCs, such as asthma, cognitive impairment, depression, smoking, obesity, disability, and lower quality of life (QOL). In fact, research indicates that most people with MCCs are of working age.

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The study compared 2 groups of adults with MCCs: those aged > 65 years with those aged < 65 years. The researchers found significant differences by age group in 18 measures, suggesting that adults aged < 65 years were “worse off” compared with those aged > 65 years. Results were similar regardless of whether diabetes, depression, hypertension, and high cholesterol were included.

Other results from BRFSS data have shown that people with ≥ 3 chronic conditions are more likely to report poor QOL than those with fewer conditions. But that analysis did not compare age groups, the researchers say. In this study, most uninsured adults were aged < 65 years, and the younger adults with MCCs were more likely to report a cost barrier to health care. They also were less likely to report a recent routine check-up. According to the study. these are important findings because managing and treating existing chronic conditions and diagnosing incident ones are key to preventing worse health in the future. The younger cohort had lower levels of well-recognized risk factors—diabetes, hypertension, high cholesterol—than the older, but their levels were still high enough to be concerning.

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A “somewhat unexpected” finding was that the younger group had a high rate of cognitive impairment. That could be the result of lack of sleep, side effects of medication, or use of illicit drugs, the researcher notes, and may not be associated with future risk of dementia. Whatever the cause, though, the researcher adds that being cognitively impaired can affect someone’s ability to manage other chronic conditions.

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