ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2019
Physical Functioning Decline and Mortality in Older Adults With Multimorbidity: Joint Modeling of Longitudinal and Survival Data.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it, 113 citations in OpenAlex.
- Pooled it
- Association between physical activity bout length and physical functioning in older adults using absolute and relative intensity thresholds: a longitudinal cohort study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Cross-sectional and longitudinal associations of activity diversity with physical function in community-dwelling older adults.Aging clinical and experimental research · 2026Article
- Age-based discrimination and healthcare utilization among older adults in India: a sequential mediation model with rural-urban differences.BMC geriatrics · 2026Article
- The interplay of multimorbidity and depressive symptoms: mediation role of functional dependence.Epidemiology and psychiatric sciences · 2026Article
- The impact of transitional care on geriatric rehabilitation outcomes: prevalence and associated factors of sarcopenia and malnutrition.Aging clinical and experimental research · 2026Observational
- U-shaped association between hemoglobin levels and cardiometabolic multimorbidity in older adults: a large-scale cross-sectional study.BMC geriatrics · 2026Article
- Association of multimorbidity with mortality risk in Chinese senior adults: a population-based cohort study.BMC geriatrics · 2026Article
- Cardiometabolic multimorbidity and cognitive-functional transitions across international ageing cohorts.Frontiers in public health · 2026Article
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- Article
- Healthy lifestyle, multimorbidity and all-cause mortality among older people: a retrospective cohort study based on CLHLS 2005-2018.BMC geriatrics · 2025Article
- Article
- Corrective Long Spinal Fusion to the Ilium for Patients with Adult Spinal Deformity Results in Good Physical Function after Mid- to Long-Term Postoperative Follow-Up.Spine surgery and related research · 2025Article
- Reduced functional independence and multimorbidity increases the risk of severe infection among older patients with Omicron: a multicenter retrospective cohort study.BMC geriatrics · 2025Article
- Relationship Between Perilesional Skin Condition and Survival in Terminally Ill Patients with Pressure Ulcers.Medicina (Kaunas, Lithuania) · 2025Observational
- Effect of happiness and functional disability on older people's survival.Cadernos de saude publica · 2025Article
- Epidemiology of Respiratory Syncytial Virus in Adults and Children With Medically Attended Acute Respiratory Illness Over Three Seasons.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Differential interplay between multimorbidity patterns and frailty and their mutual mediation effect on mortality in old age.The journal of nutrition, health & aging · 2024Article
- Interactions between patterns of multimorbidity and functional status among hospitalized older patients: a novel approach using cluster analysis and association rule mining.Journal of translational medicine · 2024Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
Background: Multimorbidity is common among older adults and strongly associated with physical functioning decline and increased mortality. However, the full spectrum of direct and indirect effects of multimorbidity on physical functioning and survival has not been quantified. We aimed to determine the longitudinal relationship of multimorbidity on physical functioning and quantify the impact of multimorbidity and multimorbidity-attributed changes in physical functioning on mortality risk. Methods: The Health and Retirement Study (HRS) is a nationally representative population-based prospective cohort of adults aged 51 or older. In 2000, participants were interviewed about physician-diagnosed chronic conditions, from which their multimorbidity-weighted index (MWI) was computed. Between 2000 and 2011, participants reported their current physical functioning using a modified Short Form-36. With MWI as a time-varying exposure, we jointly modeled its associations with physical functioning and survival. Results: The final sample included 74,037 observations from 18,174 participants. At baseline, participants had a weighted mean MWI of 4.6 ± 4.2 (range 0-36.8). During follow-up, physical functioning declined: -1.72 (95% confidence interval [CI] -1.77, -1.67, p < .001) HRS physical functioning units per point MWI in adjusted models. Over follow-up, 6,362 (34%) participants died. Mortality risk increased 8% (hazard ratio 1.08, 95% CI 1.07-1.08, p < .001) per point MWI in adjusted models. Across all population subgroups, MWI was associated with greater physical functioning decline and mortality risk. Conclusions: Multimorbidity and its associated decline in physical functioning were significantly associated with increased mortality. These associations can be predicted with an easily interpreted and applied multimorbidity index that can better identify and target adults at increased risk for disability and death.
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Registered trials
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