For the past decade, Associate Professor of Health Policy Studies Anda Botoseneanu has been studying the sometimes surprising things that can happen to our health when we accumulate multiple chronic conditions. Back in the summer of 2018, her study with Ana Quiñones of Oregon Health and Science University produced several fascinating findings about how this kind of “multiple morbidity” impacts levels of disability. Among their chief discoveries: Certain disease combinations can actually have a whole-is-greater-than-the-sum effect; equally surprising, in some cases, the combination of a physical condition (like diabetes) and a chronic mental health condition (like depression) can actually be more debilitating than a combination of two serious physical conditions.
Now Botoseneanu and Quiñones are pushing ahead with a new phase of their research — this time focusing on the development of cognitive impairment. Specifically, they want to learn whether the accumulation of some chronic disease pairings could leave people at greater risk for conditions like Alzheimer's or could lead to a faster progression of cognitive impairments. They’re also investigating differences in trends among racial groups.
To do that, Botoseneanu is again turning to a massive database from the University of Michigan called the Health and Retirement Study. One of the best longitudinal health databases in the world, the study has been continually tracking the health of some 20,000 Americans who were age 50 or over in 1992. Such data allow Botoseneanu and her colleagues to see how diseases accumulate in the study’s participants over time; and if certain disease pairings statistically correlate with other health outcomes. In this case, the focus is on common disease combinations that might be a contributor to cognitive impairment.
As in their previous study, their findings could point to improved clinical approaches for treating people with multiple morbidity. For example, if certain disease combinations, like heart disease and diabetes, were shown to put someone at greater risk of Alzheimer’s, a primary care physician could screen such patients for early signs of dementia.
Botoseneanu and Quiñones study is funded by the National Institutes of Health, which awarded the team more than $4 million to complete this latest phase of their research. UM-Dearborn’s share is $500,000 over five years.
