Zhang to Investigate Burdens of Multimorbidity in Nursing Home Residents with Obesity

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Ning Zhang, assistant professor of health promotion and policy, has received a two-year, $181,000 grant from the National Institute on Aging to investigate the burdens of multimorbidity on hospitalization and mortality in nursing home residents with obesity.

Like Americans of all ages, nursing home residents suffer increasingly from obesity, which develops frequently in the presence of other chronic conditions, including cardiovascular diseases, diabetes, arthritis and some cancers. Compared to those with normal weight, residents with obesity experience more pain with activity, and typically have more difficulty rising from a chair, walking and maintaining balance.

“Care providers in nursing homes increasingly face the prospect of simultaneously managing multiple chronic conditions and functional limitations among these residents,” says Zhang. “This places a tremendous burden on nursing home staff, who must manage multiple medications and their potential interactions, rehabilitation services and schedules, diet, and more.”

Constellations, or groupings of multiple chronic conditions, are common among both the elderly and individuals with obesity, and places individuals at much higher risk of hospitalization and mortality. Using national Minimum Data Set (MDS) and Medicare Provider Analysis and Review (MedPAR) files, Zhang hopes to characterize constellations of multimorbidity and to identify the most common concurrent conditions. Zhang will also assess the impact of constellations of multimorbidity on death and hospitalization among nursing home residents with obesity.

“We don’t yet fully understand the epidemiology of multiple chronic conditions,” says Zhang, noting that current research on the topic is limited. “By examining the constellations of conditions that are most prevalent and most important we hope to identify who is at risk of preventable hospitalization and of mortality.”

The study results, she hopes, will support clinicians and allow for targeted interventions to improve care to individuals in high-risk groups. She says, “As the population grows older and more individuals come to rely on nursing home care, it becomes more important to find ways to provide clinical interventions that will ease the burdens that multimorbidity creates for residents, caretaker