Multiple Chronic Conditions - Ages 65-74

Multiple Chronic Conditions - Ages 65-74 in Alabama

Alabama

Chronic conditions are conditions lasting more than a year that require ongoing medical attention and/or limit daily functions such as eating, bathing and mobility. Adults with multiple chronic conditions represent one of the highest-need segments of the population, as each chronic condition may require additional medication and monitoring. As the number of chronic conditions an individual has increases, the risks of the following outcomes also increase: 

• Physical, social and cognitive limitations, including subjective cognitive decline. 
• Avoidable hospitalizations.
• Adverse drug events.
• Mortality.

The economic burden from multiple chronic conditions is substantial. In 2018, Medicare beneficiaries with four or more chronic conditions made up 40% of the population but accounted for 78% of total Medicare spending. Among Medicare beneficiaries ages 65 and older, the per capita Medicare spending in 2018 for those with one or no chronic conditions was $1,956, compared with $5,663 for those with two to three conditions, $11,028 for those with four to five conditions and $31,285 for those with six or more conditions.

The prevalence of multiple chronic conditions is higher among adults ages 65 and older who are enrolled in both Medicare and Medicaid compared with those with Medicare only (excluding Medicare Advantage). Among adults ages 60-79, the prevalence of individual chronic conditions varies substantially by race and ethnicity, but there is far less racial/ethnic disparity in the prevalence of multiple chronic conditions.

While aging increases the risk of chronic diseases, such as heart disease, cancer and Type 2 diabetes, there are actions individuals can take to reduce their risk of chronic disease, including:

• Getting more physical activity, which can improve muscle function.
• Making healthy food choices, such as following the DASH Eating Plan, which has been found to help reduce the risk of hypertension and heart disease. 
• Quitting smoking and limiting the use of alcohol and other substances. 
• Visiting your medical provider regularly and making mental health a priority. 

Community-level public health strategies to prevent multiple chronic conditions among older adults include: 

• Promoting healthy environments and lifestyles. Safe communities with amenities such as walking and biking trails tend to increase physical activity among older adults. 
• Expanding the use and accessibility of clinical preventive services to ensure that older adults receive recommended screenings and immunizations. 

The Health in Aging Foundation offers tips for older adults working with a health care professional to manage care for multiple conditions. Additionally, County Health Rankings & Roadmaps has a page on evidence-based chronic disease management programs.

Healthy People 2030 does not have an objective specific to multiple chronic conditions but has several health condition-specific objectives on addiction, arthritis, cancer, chronic kidney disease, dementia, diabetes, heart disease, mental health and mental disorders, osteoporosis and respiratory disease.

Boersma, Peter, Lindsey I. Black, and Brian W. Ward. 2020. “Prevalence of Multiple Chronic Conditions Among US Adults, 2018.” Preventing Chronic Disease 17 (September): 200130. https://doi.org/10.5888/pcd17.200130.

Davis, James, Janell Penha, Omar Mbowe, and Deborah A. Taira. 2017. “Prevalence of Single and Multiple Leading Causes of Death by Race/Ethnicity Among US Adults Aged 60 to 79 Years.” Preventing Chronic Disease 14 (October): 160241. https://doi.org/10.5888/pcd14.160241.

Lee, Todd A., Alexandra E. Shields, Christine Vogeli, Teresa B. Gibson, Min Woong-Sohn, William D. Marder, David Blumenthal, and Kevin B. Weiss. 2007. “Mortality Rate in Veterans with Multiple Chronic Conditions.” Journal of General Internal Medicine 22 (S3): 403–7. https://doi.org/10.1007/s11606-007-0277-2.

Taylor, Christopher A., Erin D. Bouldin, Kurt J. Greenlund, and Lisa C. McGuire. 2020. “Comorbid Chronic Conditions Among Older Adults with Subjective Cognitive Decline, United States, 2015–2017.” Edited by Steven M Albert. Innovation in Aging 4 (1): igz045. https://doi.org/10.1093/geroni/igz045.

U.S. Department of Health & Human Services. 2010. “Multiple Chronic Conditions—A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions.” Washington, D.C.: U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/ash/initiatives/mcc/mcc_framework.pdf.

Vogeli, Christine, Alexandra E. Shields, Todd A. Lee, Teresa B. Gibson, William D. Marder, Kevin B. Weiss, and David Blumenthal. 2007. “Multiple Chronic Conditions: Prevalence, Health Consequences, and Implications for Quality, Care Management, and Costs.” Journal of General Internal Medicine 22 (S3): 391–95. https://doi.org/10.1007/s11606-007-0322-1.

Wolff, Jennifer L., Barbara Starfield, and Gerard Anderson. 2002. “Prevalence, Expenditures, and Complications of Multiple Chronic Conditions in the Elderly.” Archives of Internal Medicine 162 (20): 2269–76. https://doi.org/10.1001/archinte.162.20.2269.