The Complexity of Aging: Managing Multimorbidity in Geriatrics.

This retrospective cohort study, conducted using electronic health records from a geriatric healthcare system in Pakistan, focused on multimorbidity and polypharmacy, involving 600 participants (297 females and 303 males) with a nearly equal gender distribution. The sample was diverse in terms of socioeconomic status, with 195 (32.5%) participants hailing from high socioeconomic backgrounds, 184 (30.7%) from low socioeconomic backgrounds, and 221 (36.8%) from middle-class backgrounds. Regarding education, 139 (23.2%) had postgraduate education, and 132 (22.0%) had no formal education. In terms of living conditions, 171 (28.5%) lived alone, 146 (24.3%) in assisted living, and 145 (24.2%) in nursing homes. The mean age of participants was 81.59 years [standard deviation (SD) = 10.3], and the majority exhibited moderate physical (42.7%) and cognitive decline (45.7%). Most participants had moderate to severe multimorbidity (289 participants, 48.2%), and polypharmacy was common, with 321 (53.5%) taking five or more medications. Social isolation was high, with 289 (48.2%) participants experiencing difficulty engaging socially. Healthcare utilization was varied: 157 (26.2%) visited primary care once a month, and 169 (28.2%) attended specialist care twice a year. Hospitalization frequency averaged 4.51 visits (SD = 2.87), and emergency visits averaged 6.96 (SD = 4.22). Exploratory data analysis (EDA) identified significant correlations between polypharmacy and hospitalization frequency (r = 0.17, p<0.05) and a negative correlation with functional status (r = -0.11, p<0.05). Logistic regression revealed that polypharmacy [odds ratio (OR) = 1.35, p<0.05] and socioeconomic status (OR = 1.52, p<0.01) were significant predictors of adverse health events. This study underscores the complex healthcare needs of the elderly with multiple chronic conditions, highlighting the need for integrated care strategies to address both physical and mental health challenges.