Do you have more than one disease? Let's talk about these comorbidities!

Sometimes when we go to a doctor, some of the words they say can be a bit scary, right? One such word is 'Comorbidities'. But understanding what these are and how they affect your health can go a long way in helping you deal with your illnesses. So let's talk about this today.

So what are these comorbidities?

Simply put, comorbidities are the presence of one or more other illnesses in addition to your main illness. The medical term "morbidity" means the presence of a disease or condition. So when it is prefixed with "co" it means that two or more illnesses are present together.

The word ``Comorbidity'' can be a bit scary to hear. But once you understand what it means and how it affects your health, you can take an active role in managing your health. Because these comorbidities can affect each other, your health plan may change accordingly.

Imagine this. Your doctor tells you to walk every day to control your obesity . But a few days later, you find out that you have osteoarthritis . So, instead of walking every day, you can switch to water aerobics to prevent your joint pain from getting worse. In this case, osteoarthritis is a comorbidity with obesity. So, the way you manage your obesity changes.

Another example is high blood pressure (Hypertension) . People with other conditions, such as heart disease or lung disease, can also have high blood pressure. If you have high blood pressure along with other conditions, your doctor will also consider those conditions. He or she may need to prescribe a blood pressure-lowering medication that won't interfere with other medications you're taking.

The concept of comorbidities is very important in the medical field. So knowing what it means can help you talk to your doctor and better understand your treatment plan. It can also be useful in supporting your loved ones during their medical conditions.

Here are some other words used to describe comorbidities:

• Coexisting conditions
• Associated conditions
• Multiple chronic conditions
• Multimorbidity

What is the difference between a primary diagnosis and comorbidities?

Comorbidity is a clearly identified medical condition that you have in addition to your primary diagnosis (sometimes called the underlying diagnosis or index disease). Now you may be wondering, "What is this primary diagnosis?" The definitions of these terms are actually a bit complicated.

In the medical world, a major illness is the condition you are being treated for at a particular time or within a specific time frame. It may be the most serious illness you have, or the one that requires the most specialized care. It may even be the one that led to your hospitalization.

A disease is designated as a "main" disease by the doctor in question. Your main disease may also change depending on the doctor you see and how your health changes.

For example, imagine that you have Chronic Kidney Disease, High Blood Pressure, and Type 2 Diabetes. You see a nephrologist and are regularly treated for your kidney disease. Then, that doctor considers your kidney disease as your main disease. Because that is what he treats. He considers high blood pressure and diabetes as comorbidities of kidney disease. He also takes care of these comorbidities when treating your kidney disease.

Taking this example further, imagine that you regularly see an endocrinologist to manage your diabetes. Then that doctor considers your primary disease to be diabetes. He considers your kidney disease and high blood pressure to be comorbidities of diabetes.

So you can see, what is the main disease and what is the comorbidity can vary depending on the situation. Specialist doctors often see your health condition as a main disease and its related comorbidities.

But people like your family doctor (Primary Care Provider) may look at this a little differently. They may also use the concept of ``Multimorbidity'' to get a broader view of your health.

Is multimorbidity something like this?

The United States Department of Health and Human Services defines ``multimorbidity'' as the presence of at least two medical diseases or conditions that last for more than a year . This definition does not mention a primary disease. This is different from the definition of comorbidity.

Many researchers use the concept of ``multimorbidity'' to study how diseases affect each other. However, many people use the terms comorbidity and multimorbidity interchangeably, which is to describe the presence of two or more medical conditions together.

How do these comorbidities affect your health?

Having comorbidities or multimorbidity can affect your health in many ways. When you have two or more chronic conditions:

• These conditions can have a greater impact on your mental and/or physical health than they would individually, and can also have a more pronounced impact on your ``Health-related quality of life``.
• Due to a comorbidity, the long-term outlook for your primary disease may change.
• Treatment can be complicated. For example, a treatment for one condition may worsen another condition. Or, taking medications for different conditions together can be dangerous.
• You may need to see several different specialists . They will work together as a team, sharing their knowledge, and developing the best treatment plan for you.

Let's see what are the most common comorbidities.

A variety of comorbidities can be seen among patients receiving inpatient treatment in hospitals and among those suffering from various medical conditions.

Among those hospitalized

One study found that more than 84% of adults hospitalized in the United States in 2019 had one or more comorbidities, in addition to the underlying condition that led to their hospitalization. Nearly 50% of this group had at least three comorbidities.

The most common comorbidities found in that study were:

• High blood pressure (53.2% of inpatients)
• Diabetes (26.4% of inpatients)
• Chronic lung disease (20.5% of inpatients)
• Deficiency anemias (18.0% of inpatients)
• Obesity (17.0% of inpatients)
• Kidney disease and failure (16.3% of inpatients)

This study also found several other things:

• Comorbidities increase with age. Only 8% of adults aged 18-24 have at least three comorbidities. However, nearly 73% of those aged 85 or older have at least three comorbidities.
• Comorbidities affect outcomes. People with three or more comorbidities have longer hospital stays and are more likely to die in hospital than those with few or no comorbidities. The impact of comorbidities is particularly strong when it comes to surgery. People with three or more comorbidities are eight times more likely to die in hospital after surgery than those without comorbidities.

Comorbidities commonly seen with some major diseases

Researchers often study people with a specific disease – for example, arthritis or heart failure – to see what other conditions (comorbidities) they have. Of course, everyone is different, and these studies don’t necessarily mean that everyone with a specific disease will have certain comorbidities. But they do give us an idea of ​​common patterns.

Let's look at some examples:

• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Common comorbidities: Depression, anxiety disorders, bipolar disorder.

• Type 2 Diabetes
• Common comorbidities: High blood pressure, high blood fat levels (e.g. high cholesterol and/or high triglycerides - Dyslipidemia), Metabolic dysfunction-associated steatotic liver disease - MASLD, Polycystic Ovary Syndrome - PCOS, Obesity, Obstructive Sleep Apnea.

• Heart Failure
• Common comorbidities: Type 2 Diabetes, Sleep Apnea, Obesity, High Blood Pressure.

Sometimes, diseases occur together because they have common causes or risk factors. For example, high blood pressure and diabetes can both increase your risk of heart disease and kidney disease. But sometimes comorbidities don't have a common underlying cause. Your doctor can tell you more about the causes of your conditions and how treatment can help.

So what is the importance of you being aware of this?

Learning the meaning of the terms comorbidities and multimorbidities can help you talk to your doctor about your health. But if you feel overwhelmed by these terms, stop and think for a moment.

The important thing is not to memorize all the medical terms. The important thing is to take the time to learn about your medical conditions and how they affect your health. Understand what treatments you may need, why you need them, and how to manage your medications at home. It's also important to recognize that no two people experience the same condition or a combination of conditions differently.

Tell your doctor all your questions and concerns so he or she can give you guidance tailored to your specific situation.

The take-home message from this article is:

Okay, so, here are the most important things you need to remember from what we've talked about today:

• Comorbidities are common: the presence of one or more other illnesses in addition to a primary illness, something that many people experience.
• It's important to understand: Being aware of these comorbidities, and understanding how they affect your health, is a great help in managing your overall health.
• Treatment can be complicated: When you have more than one condition, planning treatment can be a bit complicated. Therefore, it is essential to follow your doctor's instructions exactly.
• Talk to your doctor: Tell your doctor about any medical conditions you have and any medications you take. Don't hesitate to ask any questions or concerns you have. Your healthcare team is there to help you.

Remember, you are not alone. There are many people living with these conditions. With the right knowledge, support, and medical advice, you too can cope with these conditions successfully!

` Comorbidities, Multiple Conditions, Primary Diagnosis, Multimorbidity, Chronic Diseases, Health Management, Medical Advice