Multimorbidity patterns, all-cause mortality and healthy aging in older English adults: Results from the English Longitudinal Study of Aging

Abstract

Aim: This study aimed to investigate the relationships between multimorbidity, healthy aging and mortality. Methods: Using data from 9171 individuals aged ≥50 years at wave 2 and mortality data at wave 5 of the English Longitudinal Study of Aging, a multiple linear regression model and a Cox proportional hazards model were used to investigate how multimorbidity patterns (identified as cardiorespiratory/arthritis/cataracts, metabolic and relatively healthy) were associated with a composite index of healthy aging (derived from 41 intrinsic capacity and functional ability items) and with mortality. Results: A total of 60% of the sample with multimorbidity had a moderate or high level of healthy aging. Both the cardiorespiratory/arthritis/cataracts group (n = 1826) and the metabolic group (n = 844) were negatively associated with healthy aging. The expected healthy aging index score decreased by 5.81 points (95% CI −6.69, −4.92) for the first group, and by 2.39 points (95% CI −3.54, −1.24) for the latter group. Only the cardiorespiratory/arthritis/cataracts group was positively associated with mortality. The risk of death for this group was 1.27-fold (95% CI: 1.14, 1.43) than the relatively healthy group. The relationship between multimorbidity patterns and mortality did not differ when considering levels of healthy aging. Conclusions: Although it is not impossible for people with multimorbidity to age healthily, those with the most complex combination of diseases are at higher risk of death and have lower levels of healthy aging. Geriatr Gerontol Int 2020; 20: 1126–1132.