Multiple chronic diseases threaten life expectancy

Life expectancy is continuing to increase in the United States but at a slower rate – possibly due to the increasing number of seniors living with multiple chronic medical conditions, a side effect of living longer, according to a new study from the Johns Hopkins Bloomberg School of Public Health.

The study, published in the August issue of Medical Care, is one the first studies of its kind to evaluate the effect of living with multiple chronic medical conditions on life expectancy.

“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” said lead author of the report Dr. Eva H. DuGoff in a news release. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”

Researchers analyzed the records of about 1.4 million beneficiaries enrolled in Medicare who were 67 and older and living with 21 chronic conditions, including Alzheimer’s, cancer and diabetes.

The findings showed living with only one chronic condition reduces life expectancy by a minimal amount, but for every additional condition, life expectancy is reduced by 1.8 years, according to a news release.

“The balancing act needed to care for all of those conditions is complicated, more organ systems become involved as do more physicians prescribing more medications,” said Senior author Dr. Gerard F. Anderson, in a news release.  “Our system is not set up to care for people with so many different illnesses. Each one adds up and makes the burden of disease greater than the sum of its parts.”

According to the Centers for Disease Control and Prevention, about half of all adults, around 117 million people, are living with one or more chronic medical conditions, and one in four adults is living with two or more conditions.  Additionally, in 2010, seven of the top 10 causes of death were chronic diseases, which included heart disease and cancer.

“One of the best ways to deal with multiple chronic diseases is to have a good primary care provider,” says Dr. William Rhoades, a geriatric specialist with Advocate Medical Group in Park Ridge, Ill.  “A patient seeing multiple specialists and on multiple medications needs a physician to coordinate all that care.”

Dr. Rhoades said primary care physicians generally offer several services to aid in coordinating care, which include the following:

• Diagnosing undifferentiated illnesses
• Organizing care teams
• Managing populations
• Basing care relationships on shared decision-making

For more information about primary care physicians, click here.