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Does age modify the relationship between morbidity severity and physical health in English and Dutch family practice populations?

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Abstract

Purpose

To investigate the co-influences of age and morbidity severity on physical health in adult family practice populations.

Methods

Morbidity data in a 12-month period for 7,833 older English consulters aged 50 years and over and 6,846 Dutch consulters aged 18 years and over was linked to their physical health status obtained from cross-sectional health surveys. Individual patients were categorised using 78 consulting morbidities classified by a chronicity measure (acute, acute-on-chronic and chronic) into an ordinal scale of morbidity severity ranging from single to multiple chronicity groups. Associations between morbidity severity, age and SF-12 Physical Component Summary (PCS) score were assessed using linear regression methods.

Results

Increased age and higher morbidity severity were significantly associated with poorer physical health. Of the explained total variance in adjusted PCS scores, an estimated 43% was attributed to increasing age, 40% to morbidity severity and 17% to deprivation for English consulters; the figures were 21, 42 and 31%, respectively for Dutch consulters. The largest differences in PCS scores between severity categories were observed in the younger age groups.

Conclusions

Morbidity severity and age mainly act separately in adversely influencing physical health. In ageing populations who will experience higher multimorbidity, this study underlines the importance that health care and public health will need to address morbidity severity and ageing as related but distinct issues.

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Acknowledgements

UTK is currently funded by a National Institute for Health Research Post-Doctoral Fellowship, and was funded by the Medical Research Council (MRC) Training Fellowship in Health Services Research at the start of this work. Project funding was from the Claire Wand Fund, North Staffordshire Primary Care Research Consortium, MRC Programme grant and NHS Research and Development funds.

Author information

Authors and Affiliations

  1. Arthritis Research Campaign National Primary Care Centre, Keele University, Staffordshire, ST5 5BG, UK

    Umesh T. Kadam, Martyn Lewis, Danielle A. W. M. van der Windt & Peter R. Croft

  2. NIVEL Netherlands Institute for Health Services Research, Postbox 1568, 3500, Utrecht, The Netherlands

    Francois G. Schellevis

  3. EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081, Amsterdam, The Netherlands

    Francois G. Schellevis, Danielle A. W. M. van der Windt & Henrica C. W. de Vet

  4. Executive Board, VU University Amsterdam, Boelelaan 1105, 1081, Amsterdam, The Netherlands

    Lex M. Bouter

Authors
  1. Umesh T. Kadam
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  2. Francois G. Schellevis
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  3. Martyn Lewis
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  4. Danielle A. W. M. van der Windt
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  5. Henrica C. W. de Vet
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  7. Peter R. Croft
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Corresponding author

Correspondence to Umesh T. Kadam.

Appendices

Appendix 1

Examples of the morbidities classified with a 1-year period of prevalence for English and Dutch samples (Table 4).

Table 4 Twelve-month period of prevalence (percentage figures) for the five most prevalent morbidities classified by chronicity
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Appendix 2

Comparison of sub-groups of the study to the overall groups (Table 5).

Table 5 Comparison of selected study sub-groups to the overall samples by explanatory factors in the two countries
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Kadam, U.T., Schellevis, F.G., Lewis, M. et al. Does age modify the relationship between morbidity severity and physical health in English and Dutch family practice populations?. Qual Life Res 18, 209–220 (2009). https://doi.org/10.1007/s11136-009-9442-x

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  • DOI: https://doi.org/10.1007/s11136-009-9442-x

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