Prevalence of morbidity and multimorbidity in elderly male populations andtheir impact on 10-year all-cause mortality: The FINE study (Finland, Italy, Netherlands, Elderly)

Older males are known to carry, more likely than younger people, one or mor e chronic diseases with an expected impact on mortality. This study was aim ed at identifying the relationship of prevalent chronic diseases in elderly populations of different countries with all-cause mortality. Men aged 65-8 4 from defined areas were enrolled in Finland (N=716), the Netherlands (N=8 87) and Italy (N=682), They were survivors of cohorts studied for 25 years within the Seven Countries Study. Major chronic diseases were diagnosed at entry. Ten-year follow-up for mortality was completed. Entry prevalence of selected chronic diseases was higher in Finland (56%) than in Italy (51%) a nd the Netherlands (44%), Ten-year age-adjusted death rates from ail causes were higher in Finland (565 per 1000) and lower in the Netherlands (478 pe r 1000) and Italy (445 per 1000). The absolute risk of death related to chr onic disease was high in the three countries, but was higher in Finland tha n in the Netherlands and Italy. The most lethal condition was stroke, with 10-year death rates of 806 per 1000 in Finland and 707 and 729 per 1000 in the Netherlands and Italy, respectively. The relative risk of all-cause mor tality for a set of seven chronic diseases (coronary heart disease, heart f ailure, claudicatio intermittens, cerebrovascular accidents, diabetes, COPD and cancer) adjusted by age, other diseases and cohort was less than two f or each condition, except cerebrovascular accidents in the Netherlands (RR 2.20). In general, relative risk was higher in Finland, intermediate in the Netherlands and lower in Italy, where only cerebrovascular accidents, inte rmittent claudication, diabetes and the presence of any chronic condition h ad a significant relative risk. About one third of men had one chronic dise ase, and between 10% and 15% had two diseases, The coexistence of any two o r three chronic conditions was associated with a relative risk of 2 or more in Finland and the Netherlands and less than 2 in Italy. In these elderly men prevalent morbidity and comorbidity was relatively common and it explai ned a large proportion of excess in all-cause mortality in 10 years of foll ow-up. (C) 2001 Elsevier Science Inc. All rights reserved.