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ORIGINAL RESEARCH

Multiple Chronic Medical Conditions and Health-Related Quality of Life in Older Adults, 2004–2006

The estimated direct paths between MCCs at baseline and new MCCs at follow-up are associated with ADL limitations at follow-up and physically and mentally unhealthy days at follow-up. Also shown as estimated paths are the direct associations between baseline MCCs, baseline physically unhealthy days, baseline mentally unhealthy days, demographics and control variables, new MCC at follow-up, and ADL limitations at follow-up, on physically and mentally unhealthy days at follow-up. Finally, the figure depicts the association between new MCC at follow-up and ADL limitations at follow-up. Each box represents a manifest variable with the exception of the demographics and controls, which are represented by a single box. Directional arrows depict estimated paths between the variables. Next to each endogenous variable (dependent variable) — New MCC at Follow-up, Physically Unhealthy Days at Follow-up, Mentally Unhealthy Days at Follow-up, and ADL Limitations at Follow-up — are circles that represent disturbances, or estimated error variance (ε). The double-headed arrows represent estimated correlations. The double-headed arrows between the disturbances for physically and mentally unhealthy days indicate that the error variances for these variables were correlated in the model.

Figure. Estimated mediation model at baseline and at follow-up for multiple chronic conditions (MCC), limitations in activities of daily living (ADLs), and unhealthy days. Estimated error variance is indicated by ε.

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