The impact of comorbidity on the disability of older adults: A nursing secondary analysis study
Fay, Vaunette Payton
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This non-experimental, explanatory study was conducted to determine the impact of comorbidity on the disability of older adults. The effects of age, gender, race, education, marital status and income were sought. Verbrugge's Sociomedical Disability Model was utilized as the conceptual framework for this study. The Older Americans Research and Service Center Instrument (OARS) Multidimensional Functional Assessment Questionnaire (MFAQ) was used to collect data. The sample was a nonprobability purposive sample of 477 community dwelling adults 65 years of age and older collected by Duffy and MacDonald (1990) for the study of "Determinants of Functional Health in Older Men and Woman". The majority of subjects in the sample were female (57.4%), white (60.4%), not married (61.6%), with a high school or less education (62.8%) and the average age was 75 years. The most commonly reported chronic diseases were arthritis (47.8%), hypertension (33.3%), circulation problems (29.3%), and heart trouble (23.6%); the mean number of chronic reported was 2.3%. Hierarchical multiple regression performed with total ADL score as the dependent variable indicated that the demographic variables of age and education accounted for 7.2% of the variance and the number of diseases accounted for an additional 8.7% of the variance for a total r square of 15.4, after accounting for shrinkage. Thus younger individuals, who have more education and fewer chronic conditions, have higher total ALD scores. Seven comorbid grouping variables were formed and an analysis of covariance was performed. The explained variance consisting of the covariates of age and education and the main effects were statistically significant (F = 5.7, df 8, p. =.000). A Oneway ANOVA with a post hoc Scheffe revealed that subjects with the comorbid pair of heart trouble and circulation problems had significantly (p $\le$.05), lower total ADL scores (24.2) than the group that reported no chronic disease (27.9) and also significantly differed from the group with the comorbid pair of arthritis and hypertension (26.9).