Tag Archives: multimorbidity

AGS Releases New Action Steps to Guide Care for Older Adults with Multiple Chronic Illnesses

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Journal of the American Geriatrics Society Research Summary

Caring for older adults with multiple chronic conditions can create challenging situations. For example, some treatments may be harmful to older adults who live with and manage several chronic conditions. In some cases, several treatments might be available but healthcare providers may not know which are best for a particular individual. In other cases, older adults and caregivers could even receive different treatment recommendations depending on the healthcare providers who offer guidance. Most important of all, managing care for multiple chronic conditions can make it difficult to focus on what matters most to us as individuals—a key priority when we think about the high-quality, person-centered care we all want and need as we age.

In 2010, the American Geriatrics Society (AGS) convened a panel of medical experts to address how to provide the best care for older adults living with multiple chronic conditions. The panel reviewed a host of clinical studies and developed the AGS Guiding Principles for the Care of Older Adults with Multimorbidity as a result.

The expert panel identified five “key principles” that healthcare providers should follow to support the best care for older adults with multiple chronic conditions:

  1. Include personal preferences in care decision-making. Older adults who have multiple chronic health conditions should be asked how they wish to make medical decisions affecting their care. Whenever appropriate, caregivers and family members should also be involved in these discussions.
  2. Understand the limits of evidence on treatment options. Clinicians must understand that specific, evidence-backed answers to questions about the best medical choices for individual older adults may not exist. That’s because every older adult and every health situation is unique.
  3. Weigh benefits versus harms. When addressing multiple chronic conditions for an older individual, clinicians must consider how a person might be burdened by one medical plan or treatment versus others. They also must weigh the benefits of treatment options, as well as information on the person’s functional status (their ability to perform daily activities such as bathing and eating), life expectancy (how long they are likely to live), and quality of life.
  4. Consider if treatment is manageable. When sharing recommendations, clinicians must account for the complexity of a treatment and whether it suits an older adult’s particular situation.
  5. Make the best informed choice possible. Ultimately, healthcare professionals also must try to choose therapies that have the most benefit, pose the least harm, and will work to enhance an older person’s quality of life.

Now, an expert group of geriatricians, cardiologists, and general physicians have identified a set of action steps based on those guiding principles to help healthcare providers work with older adults and caregivers to make the best treatment choices possible when addressing multiple chronic conditions.

These steps include: Continue reading →

Learning about the Impact of Multiple Symptoms in Older Adults

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Journal of the American Geriatrics Society Research Summary

“Symptoms” is the medical term for any sign of a health problem, even if that sign doesn’t help your healthcare provider diagnose a specific illness. Symptoms, such as feeling tired or rundown (also called fatigue), are among the leading causes of disability for older adults.

Sometimes symptoms are directly caused by illness—for example, an aching chest can be a symptom associated with a heart attack. But often, symptoms have multiple causes. For example, fatigue can be a common symptom when you have conditions such as knee osteoarthritis, depression, and heart failure.

What’s more, older adults often experience more than one symptom at a time, which can make each symptom feel worse.

Up until now, we haven’t had much information about how symptoms that occur at the same time affect an older adult’s ability to function. To learn more, a team of researchers recently examined information from a large study of older adults, the National Health and Aging Trends Study (NHATS), which included more than 7,500 participants aged 65 and older. The study was published in the Journal of the American Geriatrics Society. Continue reading →

Having Multiple Chronic Illnesses Plus Functional Limitations Increases Risk of Death among Older Adults with Heart Failure

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Journal of the American Geriatrics Society Research Summary

Heart failure affects more than 6 million people in the U.S.—most of whom are older adults. Roughly half the older adults who have heart failure also live with five or more other chronic health conditions. This group of people may have difficulty performing daily activities, such as walking, bathing, and eating. And older adults who have multiple chronic illnesses plus heart failure generally require more frequent health care, including more visits to healthcare providers and hospitalizations.

Recently, researchers examined the impact of having multiple chronic conditions and having difficulty with daily activities on the health of older adults with heart failure. Until now, there’s been no research on the combined effects of having all three problems for older adults. The researchers published their findings in the Journal of the American Geriatrics Society.

The researchers sent questionnaires to 6,346 older adults who had been diagnosed with heart failure; 2,692 participants returned the questionnaires and were included in the study. Continue reading →

For Older Adults with Multiple Chronic Conditions, Using Non-Drug Behavioral Treatments for Symptoms May Be Helpful

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JAGS graphicJournal of the American Geriatrics Society Research Summary

When we have several chronic health conditions as we age, the symptoms we experience can reduce our quality of life. In fact, having multiple chronic conditions is linked to symptoms that can restrict our ability to perform our daily routines. Some 70 percent of adults over the age of 75 have more than two chronic health conditions. Nearly 55 percent of Medicare recipients who have had a stroke or heart failure have five or more chronic conditions.

In a study published in the Journal of the American Geriatrics Society, researchers note that little is known about treating symptoms of multiple illnesses because people with two or more conditions are usually excluded from studies for specific diseases.

The researchers examined the results of a study that was originally designed to test how well people did after they stopped taking statin medication used to lower cholesterol levels. Their goal was to better understand the outcomes of having multiple diseases, the burden that symptoms placed on older adults, and the effects multiple chronic problems had on older adults’ ability to function. In addition, the researchers compared how a having diagnosis of cancer to having multiple chronic conditions affected an older adult’s ability to function. Continue reading →

Polypharmacy and Deprescribing

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WebDoes the number of medications you’re taking sometimes seem too high? Maybe it’s time for you and your healthcare provider to give your medication list a check-up by taking a closer look at the prescription and over-the-counter (OTC) treatments you take.

As you grow older, you’re more likely to develop health conditions that require taking multiple medications—some of which you may take for a long time. Many older people also take OTC medications, vitamins, or supplements as part of their routine care. As a result, older adults have a higher risk of overmedication, also known as “polypharmacy”—the medical term for taking four or more medications at the same time. Polypharmacy can increase your chances of unwanted reactions (also called “adverse drug reactions”) due to medications taken on their own or together.

To address this increasingly common problem, healthcare providers are focusing on how to reduce the number of medicines older adults are using through a practice called “deprescribing.” Dr. Michael Steinman, a member of the American Geriatrics Society (AGS) and a geriatrician at the University of California, San Francisco, recently appeared on WPUR—Boston’s NPR News Station—to discuss deprescribing with Dr. Barb Farrell, a pharmacist from Bruyère Geriatric Day Hospital in Ottawa, and Laura Landro, assistant managing editor at the Wall Street Journal. Hear what they had to say.

Want access to more tips and tools to help you manage multiple chronic conditions or multiple medications? We’ve got you covered.