Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability

Overview

Journal Ann Behav Med

Publisher Oxford University Press

Specialty Social Sciences

Date 2019 Dec 21

PMID 31858110

Citations 9

Authors

Courtney A Polenick

Kira S Birditt

Angela Turkelson

Helen C Kales

Affiliations

Soon will be listed here.

Abstract

Background: Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability.

Purpose: We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability.

Methods: The U.S. sample included 3,991 couples drawn from nine waves (1998-2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner's baseline depressive symptoms, and each partner's number of chronic conditions across waves.

Results: Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels.

Conclusions: Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.

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References

Lagu T, Weiner M, Hollenbeak C, Eachus S, Roberts C, Schwartz J . The impact of concordant and discordant conditions on the quality of care for hyperlipidemia. J Gen Intern Med. 2008; 23(8):1208-13. PMC: 2517982. DOI: 10.1007/s11606-008-0647-4. View

Bahler C, Huber C, Brungger B, Reich O . Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Serv Res. 2015; 15:23. PMC: 4307623. DOI: 10.1186/s12913-015-0698-2. View

McKellar J, Humphreys K, Piette J . Depression increases diabetes symptoms by complicating patients' self-care adherence. Diabetes Educ. 2004; 30(3):485-92. DOI: 10.1177/014572170403000320. View

Rosland A, Heisler M, Choi H, Silveira M, Piette J . Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help?. Chronic Illn. 2010; 6(1):22-33. PMC: 3712767. DOI: 10.1177/1742395309354608. View

Thomeer M . Multiple Chronic Conditions, Spouse's Depressive Symptoms, and Gender within Marriage. J Health Soc Behav. 2016; 57(1):59-76. PMC: 8258774. DOI: 10.1177/0022146516628179. View

Quinones A, Markwardt S, Thielke S, Rostant O, Vasquez E, Botoseneanu A . Prospective Disability in Different Combinations of Somatic and Mental Multimorbidity. J Gerontol A Biol Sci Med Sci. 2017; 73(2):204-210. PMC: 6279134. DOI: 10.1093/gerona/glx100. View

Thomeer M, Umberson D, Pudrovska T . Marital Processes around Depression: A Gendered and Relational Perspective. Soc Ment Health. 2015; 3(3):151-169. PMC: 4408555. DOI: 10.1177/2156869313487224. View

Bowling C, Plantinga L, Phillips L, McClellan W, Echt K, Chumbler N . Association of Multimorbidity with Mortality and Healthcare Utilization in Chronic Kidney Disease. J Am Geriatr Soc. 2016; 65(4):704-711. DOI: 10.1111/jgs.14662. View

Thomeer M, Reczek C, Umberson D . Gendered emotion work around physical health problems in mid- and later-life marriages. J Aging Stud. 2015; 32:12-22. PMC: 4324498. DOI: 10.1016/j.jaging.2014.12.001. View

10.

Detweiler-Bedell J, Friedman M, Leventhal H, Miller I, Leventhal E . Integrating co-morbid depression and chronic physical disease management: identifying and resolving failures in self-regulation. Clin Psychol Rev. 2008; 28(8):1426-46. PMC: 2669084. DOI: 10.1016/j.cpr.2008.09.002. View

11.

Falconier M, Kuhn R . Dyadic Coping in Couples: A Conceptual Integration and a Review of the Empirical Literature. Front Psychol. 2019; 10:571. PMC: 6443825. DOI: 10.3389/fpsyg.2019.00571. View

12.

LaPlante M . The classic measure of disability in activities of daily living is biased by age but an expanded IADL/ADL measure is not. J Gerontol B Psychol Sci Soc Sci. 2010; 65(6):720-32. PMC: 3031447. DOI: 10.1093/geronb/gbp129. View

13.

Deeks A, Lombard C, Michelmore J, Teede H . The effects of gender and age on health related behaviors. BMC Public Health. 2009; 9:213. PMC: 2713232. DOI: 10.1186/1471-2458-9-213. View

14.

Fortin M, Bravo G, Hudon C, Lapointe L, Dubois M, Almirall J . Psychological distress and multimorbidity in primary care. Ann Fam Med. 2006; 4(5):417-22. PMC: 1578652. DOI: 10.1370/afm.528. View

15.

Bock J, Luppa M, Brettschneider C, Riedel-Heller S, Bickel H, Fuchs A . Impact of depression on health care utilization and costs among multimorbid patients--from the MultiCare Cohort Study. PLoS One. 2014; 9(3):e91973. PMC: 3956806. DOI: 10.1371/journal.pone.0091973. View

16.

Smith D, Court H, McLean G, Martin D, Langan Martin J, Guthrie B . Depression and multimorbidity: a cross-sectional study of 1,751,841 patients in primary care. J Clin Psychiatry. 2014; 75(11):1202-8. DOI: 10.4088/JCP.14m09147. View

17.

Rutledge T, Loh C . Effect sizes and statistical testing in the determination of clinical significance in behavioral medicine research. Ann Behav Med. 2004; 27(2):138-45. DOI: 10.1207/s15324796abm2702_9. View

18.

Harrison M, Reeves D, Harkness E, Valderas J, Kennedy A, Rogers A . A secondary analysis of the moderating effects of depression and multimorbidity on the effectiveness of a chronic disease self-management programme. Patient Educ Couns. 2011; 87(1):67-73. DOI: 10.1016/j.pec.2011.06.007. View

19.

Polenick C, Renn B, Birditt K . Dyadic effects of depressive symptoms on medical morbidity in middle-aged and older couples. Health Psychol. 2017; 37(1):28-36. PMC: 5764774. DOI: 10.1037/hea0000573. View

20.

Raley R, Sweeney M, Wondra D . The Growing Racial and Ethnic Divide in U.S. Marriage Patterns. Future Child. 2016; 25(2):89-109. PMC: 4850739. DOI: 10.1353/foc.2015.0014. View