Nondisease-Specific Problems and All-Cause Mortality in the REasons for Geographic and Racial Differences in Stroke Study
Article first published online: 25 APR 2013
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 61, Issue 5, pages 739–746, May 2013
How to Cite
Bowling, C. B., Booth, J. N., Safford, M. M., Whitson, H. E., Ritchie, C. S., Wadley, V. G., Cushman, M., Howard, V. J., Allman, R. M. and Muntner, P. (2013), Nondisease-Specific Problems and All-Cause Mortality in the REasons for Geographic and Racial Differences in Stroke Study. Journal of the American Geriatrics Society, 61: 739–746. doi: 10.1111/jgs.12214
- Issue published online: 14 MAY 2013
- Article first published online: 25 APR 2013
- National Institutes of Health. Grant Number: 1R03AG042336
- John A. Hartford Foundation/Southeast Center of Excellence in Geriatric Medicine, and the Birmingham/Atlanta Geriatric Research
- Agency for Healthcare Research and Quality, Amgen
- NIH. Grant Number: 1K07AG31779–1A1
- NIH. Grant Numbers: NO1 HC48047, 2 P30 AG022838–06, R01 AG 039588, R01 NS 061846, 1 R01 AG021958–04, U01 NS51488
- NIH. Grant Number: HHSN268200900047C
- REGARDS study investigator. Grant Number: U01 NS51488
- NIH. Grant Number: U01 NS041588
- NIH. Grant Number: P30AG031054
- nondisease-specific problems;
To evaluate the association between six nondisease-specific problems (problems that cross multiple domains of health) and mortality in middle-aged and older adults.
Prospective, observational cohort.
U.S. population sample.
Participants included 23,669 black and white U.S. adults aged 45 and older enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.
Nondisease-specific problems included cognitive impairment, depressive symptoms, exhaustion, falls, impaired mobility, and polypharmacy. Age-stratified (<65, 65–74, ≥75) hazard ratios for all-cause mortality were calculated for each problem individually and according to number of problems.
One or more nondisease-specific problems occurred in 40% of participants younger than 65, 45% of those aged 65 to 74, and 55% of those aged 75 and older. Compared with participants with none of these problems, the multivariable adjusted hazard ratio for all-cause mortality associated with each additional nondisease-specific problem was 1.34 (95% confidence interval (CI) = 1.23–1.46) for participants younger than 65, 1.24 (95% CI = 1.15–1.35) for those aged 65 to 74, and 1.30 (95% CI = 1.21–1.39) for those aged 75 and older.
Nondisease-specific problems were associated with mortality across a wide age spectrum. Future studies should explore whether treating these problems will improve survival and identify innovative healthcare models to address multiple nondisease-specific problems simultaneously.