Faster brain decline for people with multiple diseases

Washington: A new research has found that multi-morbidity scores can help doctors understand their patients' overall prognosis and can help researchers identify risks faced by people with multiple chronic illnesses such as arthritis, diabetes, or heart disease.

In fact, the study published in the Journals of Gerontology shows that people with higher multi-morbidity weighted index or MWI scores had a much faster decline in their thinking and memory abilities than those with lower scores.

Even though most of the chronic conditions included in the index have no direct relationship to brain health, the higher a person's score, the faster they declined over a 14-year period in their ability to recall words and do simple math.

Also, the study revealed that people with higher scores were more than twice as likely to die by suicide as those with lower scores and that they had the worse mental health-related quality of life in general.

Assessing the total impact of a person's health conditions is important because 80 per cent of adults over the age of 65 have more than one condition, and 45 per cent of all adults have more than one, says Wei. The research that Melissa Wei and colleagues have done on the impacts of high MWI scores across groups of patients could also help guide care.

For instance, the finding that suicide risk rose sharply as MWI score rose could help clinicians think about which patients might be most in need of depression and suicide screening. As patients develop more conditions with age, physicians may want to monitor their mental health more closely, and offer appropriate lifestyle advice and treatment.

"As clinicians, we are more likely to assess suicide risk in people with known depression or other mental health or substance use issues, but we may not automatically consider that those with more 'physical' conditions only could also be at higher risk," said Wei.

"Multi-morbidity has several downstream consequences. Physical impairments are just the beginning. As conditions accumulate and physical functioning deteriorates, we have found this is closely linked to worse mental health, social health, and eventually premature mortality," she added.

Using scores clinically could also help providers ensure that patients with high scores receive care management services or other support to help them live their best life and keep on top of the tests, treatments and lifestyle changes that can help them do so.