Prevalence of Multi-Morbidity and Frailty at Death over the Age of 50 in Italy

France Meslé, Institut National d'Études Démographiques (INED)
Viviana Egidi, Sapienza Università di Roma
Aline Désesquelles, Institut National d'Études Démographiques (INED)
Luisa Frova, Istituto Nazionale di Statistica (ISTAT)
Marilena Pappagallo, Istituto Nazionale di Statistica (ISTAT)
Francesco Grippo, ISTAT

Mortality statistics based on the underlying cause of death are very powerful to understand the fluctuations of mortality as well as the differences between subpopulations or between countries, and to inform about relevant targets for public health policies. With increased life expectancy, an ever-growing population is living with several diseases. Multi-morbid patients represent a major challenge for health systems as well as for caregivers. As a consequence, mortality analysis needs to extend to the monitoring of multi-morbidity at death. We present a classification of death records based on all causes reported on death certificates. Our aim is to summarize this information according to two criteria: multi-morbidity and frailty, which is another symptom of aging populations. We developed decision rules that enable to identify multi-morbid processes, and we were able to automate them. Data are for all deaths at age 50 and over that occurred in Italy in 2014. Multi-morbid processes represent the majority of the morbid processes, rising from 43% at 50-54 years to 63% at ages 85-89. Simple processes are more frequent at young ages than at older ages, where they still represent one third of the deaths. Multi-morbidity at death is more frequent among males but age-patterns of both genders are identical. About one out of four deaths over the age of 50 involve frailty symptoms, rising from 7% at age 50-54 to 45% at age 95+. Frailty at death is more frequent among females but mortality rates involving frailty are similar for males and females.

Presented in Session 9: Mortality and Longevity