National Trends of the 5Ms of Geriatric Medicine, NHANES 2001-2018

TL;DR

This study shows that the prevalence of geriatric syndromes, known as the 5Ms, is increasing among U.S. adults, especially in mobility and multi-complexity domains.

Contribution

The study provides the first national trends of the 5Ms of Geriatric Medicine using NHANES data from 2001 to 2018.

Findings

The prevalence of at least one geriatric syndrome increased from 62% to 69% between 2001 and 2018.

Mobility and Multi-complexity domains showed the greatest increases in both middle-aged and older adults.

Two-thirds of U.S. adults have at least one geriatric syndrome, highlighting the need for age-friendly care.

Abstract

Age-friendly care of older adults embodies the Geriatric-5Ms, a framework spanning domains: Mind, Mobility, Medications, Multi-complexity, and Matters most. How the prevalence of these 5 geriatric syndromes is changing among U.S. adults is unknown. We analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) using sampling weights to generate nationally representative estimates of the 5Ms in U.S. adults from 2001-2018. The geriatric syndromes (i.e. 5Ms) were defined by self-report of depression or cognitive impairment (Mind), functional impairments (Mobility), polypharmacy (Medications), >2 chronic conditions (Multi-complexity), and self-reported poor health (Matters Most). We estimated the prevalence of each of the 5Ms and performed age-stratified and sex-adjusted logistic regression to assess temporal trends. The cohort included 47,954 U.S. adults (38% younger, age 20-39; 45% middle-aged, age 40-64; 18% older, age ≥65; 52% female; 68% White). Overall, the prevalence of having at least one geriatric syndrome increased from 62% to 69% between 2001-2018, with greatest increases in the Mobility and Multi-complexity domains. In older adults, prevalence of Multi-complexity was highest of the 5Ms (93%), while the Medication domain increased the most over time (29% to 44%). In both middle-aged and older adults, the prevalence is increasing at similar rates in Mobility (middle-aged: 23% to 32%; older: 70% to 77%) and Multi-complexity (middle-aged: 63% to 70%; older: 85% to 93%) domains. Two-thirds of U.S. adults have at least one geriatric syndrome. The burden of the 5Ms is growing in middle-aged and older adults suggesting a need for age-friendly care across the lifespan.