Quality of Life Research

, 18:209 | Cite as

Does age modify the relationship between morbidity severity and physical health in English and Dutch family practice populations?

  • Umesh T. KadamEmail author
  • Francois G. Schellevis
  • Martyn Lewis
  • Danielle A. W. M. van der Windt
  • Henrica C. W. de Vet
  • Lex M. Bouter
  • Peter R. Croft



To investigate the co-influences of age and morbidity severity on physical health in adult family practice populations.


Morbidity data in a 12-month period for 7,833 older English consulters aged 50 years and over and 6,846 Dutch consulters aged 18 years and over was linked to their physical health status obtained from cross-sectional health surveys. Individual patients were categorised using 78 consulting morbidities classified by a chronicity measure (acute, acute-on-chronic and chronic) into an ordinal scale of morbidity severity ranging from single to multiple chronicity groups. Associations between morbidity severity, age and SF-12 Physical Component Summary (PCS) score were assessed using linear regression methods.


Increased age and higher morbidity severity were significantly associated with poorer physical health. Of the explained total variance in adjusted PCS scores, an estimated 43% was attributed to increasing age, 40% to morbidity severity and 17% to deprivation for English consulters; the figures were 21, 42 and 31%, respectively for Dutch consulters. The largest differences in PCS scores between severity categories were observed in the younger age groups.


Morbidity severity and age mainly act separately in adversely influencing physical health. In ageing populations who will experience higher multimorbidity, this study underlines the importance that health care and public health will need to address morbidity severity and ageing as related but distinct issues.


Ageing Comorbidity Epidemiologic studies Family practice Quality of life 



UTK is currently funded by a National Institute for Health Research Post-Doctoral Fellowship, and was funded by the Medical Research Council (MRC) Training Fellowship in Health Services Research at the start of this work. Project funding was from the Claire Wand Fund, North Staffordshire Primary Care Research Consortium, MRC Programme grant and NHS Research and Development funds.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Umesh T. Kadam
    • 1
    Email author
  • Francois G. Schellevis
    • 2
    • 3
  • Martyn Lewis
    • 1
  • Danielle A. W. M. van der Windt
    • 1
    • 3
  • Henrica C. W. de Vet
    • 3
  • Lex M. Bouter
    • 4
  • Peter R. Croft
    • 1
  1. 1.Arthritis Research Campaign National Primary Care CentreKeele UniversityStaffordshireUK
  2. 2.NIVEL Netherlands Institute for Health Services ResearchUtrechtThe Netherlands
  3. 3.EMGO InstituteVU University Medical CenterAmsterdamThe Netherlands
  4. 4.Executive BoardVU University AmsterdamAmsterdamThe Netherlands

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