The Importance of Managing Chronic Diseases

Q. I am middle aged and overweight with diabetes and high blood pressure. My friend told me that he read somewhere that having two or more chronic health conditions in middle life puts people at a higher risk of developing dementia in later life. Is this true? Either way, I recently joined the gym and am going to start exercising and eating better to live longer.

A. Kudos on your positive life changes! It is true that people in their mid-50s who have two or more chronic health conditions are at a higher risk of developing dementia later in life, according to a long-term study published in the British Medical Journal.

Researchers at the University College London and the University of Paris recently revisited a study that being 35+ years ago to find out if there was an association between multi-morbidity (having two or more long-term diseases or health conditions) and dementia.

The Whitehall II Study Began in 1985 and is Being Revisited Today

A long-term health study involved 10,095 people, who were enrolled from 1985 to 1988. The participants ranged in age from 35 to 55 and they didn’t have dementia. Over the years, they received clinical examinations and were linked to national health, mental health, and mortality registries, and the study has been revisited several times to track progress.

Researchers defined morbidity as having at least two chronic conditions from a predefined list of 13 chronic conditions that included:

• Arthritis;
• Cancer;
• Chronic kidney disease;
• Chronic obstructive pulmonary disease;
• Coronary heart disease;
• Depression;
• Diabetes;
• Heart failure;
• Hypertension;
• Liver disease;
• Mental disorders;
• Parkinson’s disease; and/or
• Stroke.

The study has been revisited several times over the years. The following were some of the updated findings of the study after the most recent follow-up:

• Of the total number of participants, 6.6% had two or more chronic conditions at age 55. As people got older, the number of people having two or more chronic conditions increased to 32 % at age 70. After an average 32-year follow-up, researchers identified 639 cases of dementia;
• After taking into account factors such as age, ethnicity, gender, education, marital status, lifestyle behaviors including diet and physical activity, participants with two or more chronic conditions at age 55 had more than twice the risk (2.4-fold) of developing dementia compared to people who did not have any of the 13 chronic conditions. Participants who developed two or more conditions between ages 60 and 65 had a 1.5-fold higher risk of developing dementia;
• Investigators further found that participants with three or more chronic conditions at age 55 had five times the risk of developing dementia. People who were 70 years old when they developed chronic health conditions had nearly twice the risk of dementia;
• Researchers found that for every five years younger a person was when multi-morbidity occurred up to the age 70, the risk of dementia increased by 18%;
• The increased severity of the chronic conditions strengthened the association with dementia, according to the study.

Why Prevention and Management of Chronic Diseases is Imperative

The findings from the study show how having multiple chronic diseases over the years can increase someone’s risk of dementia. On a positive note, prevention and management of these chronic diseases over the course of adulthood can mitigate adverse outcomes in old age.

Why it’s Important to Manage Chronic Diseases

According to Dr. Rosa Sancho, Head of Research at Alzheimer’s Research UK, “(t)he study’s findings show the importance of properly managing long-term health conditions. We do know that it’s never too early or too late in life to take action on brain health and there are things we can do to reduce our risk of dementia.”

Dr. Sancho also states that “actions that help to keep our brains healthy as we age include not smoking, drinking in moderation, staying mentally and physically active, eating a balanced diet, and keeping cholesterol and blood pressure levels in check.”

Professor Paul Morgan, a Group Leader at the Dementia Research Institute at Cardiff University, in Cardiff, United Kingdom, agreed that “(r)educing inflammation in people with multi-morbidities, as well as aggressively treating the underlying disease, might prevent or delay dementia onset.”

Chronic Disease Self-Management and How it Works

80% of older adults live with least one chronic disease, and 68% have at least two. Many adults with chronic conditions struggle to manage them. Chronic disease self-management programs can help older adults gain control of their symptoms and live healthier lives.

To maintain healthy lives, people with chronic or long-term conditions and their families have to manage their condition from day to day. Self-management often involves medical treatments and therapies. It can also mean making lifestyle changes, such as eating better, reducing stress, or increasing exercise. You might also need to make changes in your life, such improving work or family relationships or changing how you interact with health care providers.

Self-Management of Chronic Disease can include the following:

• Techniques to deal with problems such as frustration, fatigue, pain, and isolation;
• Appropriate exercise for maintaining and improving strength, flexibility, and endurance;
• Appropriate use of medications;
• Communicating effectively with family, friends, and health professionals;
• Managing depression;
• Better breathing techniques;
• Relaxation techniques;
• Healthy eating habits;
• Making good decisions about your health;
• How to evaluate new treatments.

In Virginia, Maryland, and DC, Living Well is a Chronic Disease Self-Management Program. The Living Well Self-Management Program is a Stanford-developed evidence based workshop for adults with more than one health issue. Read today’s Critter Corner for more details on this program in the DC Metro area.

Learn more about chronic disease and ways to manage it here:

• Chronic Disease Information In Your State
• CDC Chronic Disease Information
• Center for Healthy Aging for Professionals: Get the Facts on Chronic Disease Self-Management

Do you have a Loved One with Dementia or a Chronic Disease?

If you have a loved one who suffers from dementia or any chronic illness, it is important to start appropriate estate planning and asset protection planning as soon as possible. Please call us to make an appointment for an initial consultation:

Medicaid Planning Attorney Fairfax, VA: 703-691-1888
Medicaid Planning Attorney Fredericksburg, VA: 540-479-1435
Medicaid Planning Attorney Rockville, MD: 301-519-8041
Medicaid Planning Attorney Washington, DC: 202-587-2797