Adults with multiple chronic conditions becoming more common in U.S.

Middle-aged and older patients with multiple chronic conditions increased in last 10 years, according to CDC study.

Significantly more U.S. adults 45 years and older have multiple chronic conditions now than did 10 years ago, according to a Data Brief released by the CDC National Center for Health Statistics. This increase was seen in men and women, in all racial and ethnic groups examined, and in most income groups.

In 1999–2000, 16.1% of adults 45 years old to 64 years old and 37.2% of adults 65 years and older had multiple chronic conditions according to the National Health Interview Survey definition—at least two of hypertension, heart disease, diabetes, cancer, stroke, chronic bronchitis, emphysema, current asthma, and kidney disease. By 2009–10, those percentages had grown to 21.0% and 45.3%, respectively.

Significant increases were seen in men and women in both age groups. In addition, significantly more non-Hispanic black and white adults and Hispanic adults in both age groups had multiple chronic conditions in 2009–10. Non-Hispanic black adults experienced the highest prevalence in both age groups and in both time periods, CDC noted.

Higher income was associated with a lower prevalence of two or more chronic conditions in both time periods. The prevalence in 2009–10 among adults 45 years to 64 years old living below the poverty line was more than twice that of those living at 400% or more of the poverty level (33.4% vs. 15.7%). The prevalence of two or more chronic conditions was higher across all income levels among patients 65 years and older. In the older age group, prevalence decreased with rising income as well; however, the percentage varied less than it did in the younger age group.

Perhaps most alarmingly, significantly more adults 45 years to 64 years old with multiple chronic conditions did not receive or delayed receiving medical care or prescription drugs due to cost in 2009–10 compared with 1999–2000. In 1999–2000, 17.2% of adults in this age group didn’t receive medical care and 14.2% didn’t get prescription drugs; 10 years later, those percentages grew to 23.4% and 21.5%, respectively. Adults 65 years and older were much less likely than those in the younger age group to delay or skip medical care or prescription drugs. There was a significant, if small, increase in those who didn’t get needed prescription drugs between 1999–2000 and 2009–10, however.

These increases in multiple chronic conditions were driven mostly by increases in three conditions among patients 45 years and older, CDC noted: hypertension (35% in 1999–2000 vs. 41% in 2009–10), diabetes (10% vs. 15%), and cancer (9% vs. 11%). The agency also pointed out that these increases have serious implications for the health care system, as patients with multiple chronic conditions are more likely to be hospitalized, fill more prescriptions, have higher annual prescription drug costs, and have more physician visits.