BACKGROUND With increasing age, having multiple chronic conditions is the norm. It is of importance to study how co-existence of diseases affects functioning and mortality among older persons. Complex multimorbidity may be defined as three or more conditions affecting at least three different organ systems. The aim of this study was to investigate how complex multimorbidity affects activities of daily living and mortality amongst older Norwegians. METHODS Participants were 60-69-year-olds at baseline in the Nord-Trøndelag Health Study 1995-1997 (HUNT2) n = 9058. Multinomial logistic regression models were used to investigate the association between complex multimorbidity in HUNT2, basic and instrumental activities of daily living in HUNT3 (2006-2008) and mortality during follow-up (n = 5819/5836). Risk ratios (RR) and risk differences (RD) in percentage points (pp) with 95% confidence intervals (CI) were reported. RESULTS 47.8% of 60-69-year-olds met the criteria of complex multimorbidity at baseline (HUNT2). Having complex multimorbidity was strongly associated with the need for assistance in IADL in HUNT3 11 years later (RR = 1.80 (1.58-2.04) and RD = 8.7 (6.8-10.5) pp) and moderately associated with mortality during the follow-up time (RR = 1.22 (1.12-1.33) and RD = 5.1 (2.9-7.3) pp). Complex multimorbidity was to a lesser extent associated with basic activities of daily living 11 years later (RR = 1.24 (0.85-1.83) and RD = 0.4 (- 0.3-1.1) pp). CONCLUSIONS This is the first study to show an association between complex multimorbidity and activities of daily living. Complex multimorbidity should receive more attention in order to prevent future disability amongst older persons.

中文翻译：

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挪威老年人群的复杂多发病率，日常生活活动和死亡率之间的关联。前瞻性队列研究：HUNT研究，挪威。

背景技术随着年龄的增长，具有多种慢性疾病是常态。研究疾病的共存如何影响老年人的功能和死亡率至关重要。复杂的多发病率可以定义为影响至少三个不同器官系统的三个或更多状况。这项研究的目的是调查复杂的多发病率如何影响挪威老年人的日常生活和死亡率。方法1995-1997年Nord-Trøndelag健康研究（HUNT2）的基线年龄为60-69岁（n = 9058）。采用多项Logistic回归模型研究HUNT2的复杂多发病率，基础和工具活动之间的关系。 HUNT3（2006-2008）的日常生活和随访期间的死亡率（n = 5819/5836）。报告了以95％置信区间（CI）表示的风险比（RR）和风险差异（RD）的百分比（pp）。结果60.69岁的儿童中有47.8％符合基线时的复杂多发病标准（HUNT2）。患有复杂的多发病与11年后接受HUNT3治疗的IADL的需要密切相关（RR = 1.80（1.58-2.04）和RD = 8.7（6.8-10.5）pp），并与随访期间的死亡率中等相关（ RR = 1.22（1.12-1.33 pp）和RD = 5.1（2.9-7.3）pp）。复杂的多发病在较小程度上与11年后的日常生活基本活动有关（RR = 1.24（0.85-1.83）和RD = 0.4（-0.3-1.1）pp）。结论这是第一个显示复杂的多发病与日常生活活动之间的联系的研究。