Multimorbidity: putting the pieces together

Multimorbidity is rarely discussed in casual conversations. How do you know if you have it? When does it affect your overall health? What can you do to prevent or support it?

In this article, Danielle Hansen, D.O., geriatric and internal medicine specialist at LECOM Institute for Successful Aging, explains the importance of identifying multimorbidity so proper treatment plans can be developed.

What is multimorbidity?

In common communication, people talk about comorbidity. Most people, as they grow older, have more than one chronic condition. Whenever you have two or more chronic conditions it’s called multimorbidity.

When we consider how to develop a treatment plan with you, we’re dealing with all of your medical problems and not just one of those chronic conditions.

It’s important to understand all of the different diseases you have, how they’re interfering or interacting with one another, as well as how our treatment approach needs to be modified or changed based on those diseases and their interactions.

We also need to consider all the medications we would potentially use for treatment:

Would one medication for one of the diseases cause problems for another? We have to figure that all out together and put the pieces together.

What is a chronic condition?

Chronic would be a condition that is not acute; it is something that lasts for a while. You might be familiar with things like high blood pressure or diabetes. These are things that don’t just go away.

With a lot of advances in treatment, people are now able to live for many years with diseases that were once considered an acute illness. Some cancers, for example, can be treated now as a chronic condition or comorbidity because people with cancer might live for years and years and years with that disease.

The same is true for HIV/AIDS. In the past we thought people would pass away from the disease in a short time, but now people are living with it for decades because of advances in treatment.

More recently, we have been talking about COVID-19. Long COVID symptoms or syndrome is likely going to be a new comorbidity disease for us to deal with in the future.

We consider all the diseases you may have collectively, and then figure out what matters most to you, to put all the pieces together to come up with a treatment plan.

What are the pros and cons of doing your own research on multimorbidity?

Oftentimes, you conduct a lot of research on your own before you ever come to the doctor, or in between visits, to look at different potential treatment options or to try and figure out what’s going on with your health. This is fantastic! We want you to do that – but we also want to make sure you’re using good sources.

We want you to use reputable sources, things that are science based, when researching things on the internet.

When you look up a specific disease, please understand it’s not going to necessarily match your situation because patients come with multiple diseases, or multimorbidity.

If you read something on the internet, it may not be an appropriate treatment for you. The person on the internet may have disease A, but not disease B.

Much of the research that’s been done has been done on single diseases. That treatment works for the single disease, but it doesn’t tell us what to do if you have two or more diseases that might interfere with one another, so, again, we may have to modify the treatment approach based on all of that information.

What steps can you take to prevent multimorbidity?

Preventative healthcare is the same for most everything: exercising regularly, eating healthy, seeing your provider regularly so you can have all the preventative things done – vaccinations, cancer screenings and more, based on your demographic information, age, gender, etc.

Every three months is a typical interval for us to see patients when they have multiple medical problems because we need to monitor them. Things can change fairly quickly. Sometimes those changes are subtle, so it’s important to detect them early so we can adjust your treatment plan and lifestyle and be able to respond appropriately.

Even if you’re feeling well, get to the doctor. Sometimes there are things we’re looking for such as medications you’re on that might not be as clear on the outside.

We see patients starting at age 50, but life expectancy is much later than age 50. Normal aging processes happen. The best thing you can do is get plenty of rest, eat healthy and exercise. Sleep restores your body’s ability – including your brain’s ability – to function while you’re awake.

Danielle Hansen, D.O.

Call (814) 868-3488 to schedule an appointment with Dr. Hansen at LECOM Institute for Successful Aging.