Cohort Trends in the Burden of Multiple Chronic Conditions Among Aging U.S. Adults

Nicholas J. Bishop, Steven A. Haas, Ana R. Quiñones

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Multimorbidity, also referred to as multiple chronic conditions (MCCs), is the concurrent presence of 2 or more chronic health conditions. Increasing multimorbidity represents a substantial threat to the health of aging populations. Recent trends suggest greater risk of poor health and mortality among later-born cohorts, yet we are unaware of work examining cohort differences in multimorbidity among aging U.S. adults. METHODS: We examine intercohort variation in MCC burden in adults aged 51 years and older using 20 years (n = 33,598; 1998-2018) of repeated assessment drawn from the Health and Retirement Study. The index of MCCs included 9 chronic conditions (heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer excluding skin cancer, high depressive symptoms, and cognitive impairment). We used linear mixed models with various approaches to estimate age/period/cohort effects to model intercohort patterns in MCC burden. We also explored variation in the specific conditions driving cohort differences in multimorbidity. RESULTS: More recent cohorts had greater MCC burden and developed multimorbidity at earlier ages than those born to prior generations. The burden of chronic conditions was patterned by life-course sociodemographic factors and childhood health for all cohorts. Among adults with multimorbidity, arthritis and hypertension were the most prevalent conditions for all cohorts, and there was evidence that high depressive symptoms and diabetes contributed to the observed cohort differences in multimorbidity risk. DISCUSSION: Our results suggest increasing multimorbidity burden among more recently born cohorts of aging U.S. adults and should inform policy to address diminishing health in aging populations.

Original languageEnglish (US)
Pages (from-to)1867-1879
Number of pages13
JournalThe journals of gerontology. Series B, Psychological sciences and social sciences
Volume77
Issue number10
DOIs
StatePublished - Oct 6 2022

Keywords

  • Baby Boom cohort
  • Health and Retirement Study
  • Life course
  • Multimorbidity
  • Population aging

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies

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