Research Article

Deconstructing Complex Multimorbidity in the Very Old: Findings from the Newcastle 85+ Study

Table 1

20 diseases and geriatric conditions examined; data sources and ascertainment criteria.

Diseases (15)
DiseaseData sourceCriteria

HypertensionGeneral practice (GP) recordsDocumented diagnosis of hypertension regardless of date.
Ischaemic heart diseaseGP records and health assessment (HA) electrocardiogram (ECG)Documented diagnosis of angina or myocardial infarction or coronary artery bypass grafts or coronary angioplasty or coronary stent regardless of date. Participants without a preexisting diagnosis could be additionally assigned on the basis of Minnesota codes [21] commencing 1-1 or 5-1 on 12 lead ECG conducted as part of the health assessment.
Heart failureGP recordsDocumented diagnosis of heart failure regardless of date.
Atrial fibrillation or flutterHA ECGMinnesota codes 8-3-1 or 8-3-2 on 12 lead ECG conducted as part of the health assessment.
Cerebrovascular diseaseGP recordsDocumented diagnosis of stroke or transient ischaemic attack or carotid endarterectomy regardless of date.
Peripheral vascular diseaseGP recordsDocumented diagnosis of peripheral vascular disease regardless of date.
OsteoarthritisGP recordsDocumented diagnosis of osteoarthritis or cervical spondylosis or lumbar spondylosis regardless of date.
Inflammatory arthritisGP recordsDocumented diagnosis of rheumatoid arthritis or psoriatic arthropathy or ankylosing spondylitis regardless of date.
OsteoporosisGP recordsDocumented diagnosis of osteoporosis regardless of date.
Chronic obstructive pulmonary diseaseGP recordsDocumented diagnosis of chronic obstructive pulmonary disease (COPD) regardless of date.
AsthmaGP recordsDocumented diagnosis of asthma excluding childhood asthma and excluding asthma in conjunction with COPD.
Thyroid diseaseGP recordsDocumented diagnosis of hypothyroidism or hyperthyroidism regardless of date.
Diabetes mellitusGP recordsDocumented diagnosis of diabetes mellitus regardless of date.
Cancer within previous 5 yearsGP recordsDocumented diagnosis of cancer diagnosed within previous 5 years excluding nonmelanoma skin cancer.
Renal impairmentHA serum creatinine Estimated glomerular filtration rate of less than 45 mL/min/1.73 m2 calculated using the Chronic Kidney Disease Epidemiology Collaboration equation [22] using serum creatinine measured as part of the health assessment. This cut point identifies Stages 3B, 4, and 5 Chronic Kidney Disease [23].

Geriatric conditions (5)
Geriatric conditionData sourceCriteria

Urinary incontinenceHA questionnaireModerate, severe, or profound incontinence (classified on basis of frequency of episodes and volume of urine leakage [24]) or catheterised for previous 12 months.
FallsHA questionnaireTwo or more falls in previous 12 months.
Visual impairmentHA questionnaireSelf-reported difficulty recognizing a friend across the road or reading ordinary newsprint, with aids if worn.
Hearing impairmentHA questionnaireSelf-reported difficulty hearing someone taking in a quiet room or following a conversation with background noise, with aids if worn.
Cognitive impairmentHA cognitive testStandardised minimental state examination score [25] of 21 or lower.