Dr. Kathryn Nicholson is completing her post-doctoral fellowship in the Department of Health Research Methods, Evidence and Impact at McMaster University in Hamilton, Ontario, Canada. She previously completed her doctoral dissertation in the Department of Epidemiology & Biostatistics at Western University in London, Ontario, Canada. She has a keen interest in the areas of multimorbidity, polypharmacy, ageing, primary health care and the use of large longitudinal datasets to examine the maintenance of health and/or the occurrence of disease across the life course.
Examining the accumulation of multiple chronic diseases and multiple prescribed medications using two national cohorts of older adults in Canada
Context: The lifespan of populations around the world has increased dramatically because of innovations in clinical medicine and public health interventions. This important achievement must be matched with a corresponding increase in health span. However, research has demonstrated that living longer is not synonymous with an increase in health span or healthy ageing. This discrepancy translates into life years deprived of full health due to the accumulation of multiple chronic diseases (multimorbidity) and multiple prescribed medications (polypharmacy).
Objectives: The first objective is to determine the presence and accumulation of multimorbidity and polypharmacy among older adult primary health care patients across Canada. The second objective is to describe the presence and accumulation of multimorbidity and polypharmacy among older adult community-dwelling participants across Canada, as well as their relationships with elements of satisfying ageing including the presence of disability, frailty, social participation or satisfaction with life.
Setting: For the first objective, data have been derived from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) electronic medical record database that holds more than 1.5 million longitudinal, de-identified patient records. For the second objective, data have been derived from the Canadian Longitudinal Study on Aging (CLSA) survey database that holds robust physiological and psychosocial measures for more than 50,000 community-dwelling adults. All analyses will be conducted using Stata 14.2 software.
Anticipated Results: Using the CPCSSN database, the sequence of chronic disease diagnoses and prescribed medications will be explored over time among older adult primary health care patients and the extent to which these combinations and permutations vary by patient characteristics (such as sex, age and geographic location). Using the CLSA database, the overlap among older adult community-dwelling participants living with multimorbidity and polypharmacy will be determined, as well as the extent to which health-related outcomes (such as disability, frailty, social participation and satisfaction with life) are impacted by the presence of multimorbidity and/or polypharmacy.
Conclusions: This research will enhance our understanding of the profiles of ageing using two national, longitudinal datasets in Canada. More specifically, this research will provide information on the occurrence of multimorbidity and polypharmacy over time, as well as the relationship with elements of satisfying ageing. In understanding these prominent challenges to healthy ageing