Multi-morbidity and frailty at death: a classification of death records for an aging world

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

With increased life expectancy, an ever-growing population is living with several diseases and/or with frailty. Frail people are at higher risks of dying. Multi-morbid patients also represent a major challenge for health systems and caregivers. The Covid pandemics highlights the importance of monitoring the contribution of multi-morbidity to death processes. We present a method that enables to classify cause-of-death records according to the presence/absence of multi-morbidity and/or frailty. We developed decision rules in line with WHO recommendations, 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.

Keywords: Mortality, Health and morbidity, Population ageing, Methodology

See extended abstract.

  Presented in Session 20. Mortality and Causes of Death