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Strategies Needed to Treat Comorbid Chronic Diseases

Understanding associated disease patterns key to improving health care management in elderly

TUESDAY, Sept. 11 (HealthDay News) -- Rather than treat a specific disease in older adults, clinicians may better improve overall health by identifying associated conditions and developing appropriate intervention strategies, according to a research letter published in the Sept. 12 issue of the Journal of the American Medical Association.

Carlos O. Weiss, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data from the National Health and Nutrition Examination Survey involving 4,349 patients aged 65 and older with any of five diseases linked to higher mortality rates -- arthritis, cerebrovascular accident, chronic lower respiratory tract disease, coronary heart disease and diabetes mellitus. They looked at the number of patients with a single disease and those with at least one other coincident disease and compared outcomes to pinpoint effective interventions.

The majority of patients with a chronic disease had at least one related condition. Among older women, 47.2 percent with arthritis, 17 percent with heart disease, 18.6 percent with respiratory disease, and 17.1 percent with diabetes had no associated conditions; rates were similar to those of older men.

"Single-disease clinical practice guidelines may not be relevant for large proportions of individuals with disease, particularly if the guidelines do not consider drug-drug and drug-disease interactions," the authors write. "Recognizing that some specific combinations of diseases are common may allow strategies targeted to a pattern."

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