Abstract
BackgroundWith the number of centenarians increasing exponentially in Spain, a deeper knowledge of their socio-demographic, clinical, and healthcare use characteristics is important to better understand the health profile of the very elderly.MethodsWe conducted a retrospective, cross-sectional observational study in the EpiChron Cohort (Aragón, Spain) aimed at analyzing the socio-demographic, clinical, drug use and healthcare use characteristics of 1680 centenarians during 2011–2015, using data from electronic health records and clinical-administrative databases.ResultsSpanish centenarians (79.1% women) had 101.6 years on average. Approximately 80% of centenarians suffered from multimorbidity, with an average of 4.0 chronic conditions; 50% were exposed to polypharmacy, with an average of 4.8 medications; only 6% of centenarians were free of chronic diseases and only 7% were not on medication. Centenarians presented a cardio-cerebrovascular pattern in which hypertension, heart failure, cerebrovascular disease and dementia were the most frequent conditions. Primary care was the most frequently visited healthcare level (79% of them), followed by medical specialist consultations (23%), hospitalizations (13%), and emergency service use (9%).ConclusionsMultimorbidity is the rule rather than the exception in Spanish centenarians. Addressing medical care in the very elderly from a holistic geriatric view is critical in order to preserve their health, and avoid the negative effects of polypharmacy.
Highlights
With the number of centenarians increasing exponentially in Spain, a deeper knowledge of their socio-demographic, clinical, and healthcare use characteristics is important to better understand the health profile of the very elderly
For the analysis of multimorbidity, defined as the co-occurrence of two or more chronic diseases, we considered all 114 of the Expanded Diagnostic Clusters (EDCs) defined as chronic by Salisbury et al [23]
This study describes the socio-demographic, clinical and healthcare use characteristics of 1680 Spanish centenarians of the EpiChron Cohort between 2011 and 2015 based on electronic health records and clinical-administrative data sources
Summary
With the number of centenarians increasing exponentially in Spain, a deeper knowledge of their socio-demographic, clinical, and healthcare use characteristics is important to better understand the health profile of the very elderly. The rates of multimorbidity (i.e., presence of two or more chronic diseases) [4] and of its associated negative consequences such as higher risk of polypharmacy, disability and functional decline, and inappropriate healthcare use (e.g., hospitalizations by ambulatory care sensitive conditions, readmissions to hospital in a short period of time, overutilization of healthcare services) [5] could be expected to increase in centenarians as the burden of chronic diseases consistently grows with age [6,7,8]. Some studies suggest that the burden of chronic conditions in centenarians is low, with low lethality rates [10, 15, 16] and low healthcare use [17]. The Danish Centenarian Study [9] showed high levels of morbidity, in hypertension (52%), dementia (51%), ischemic heart disease (27%), and strokes (22%); and a study of Tokyoite centenarians [18] found that more than 95% of them had chronic diseases
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