Multimorbidity and decision-making preferences among older adults

Winnie C. Chi, Jennifer Wolff, Raquel Greer, Sydney Dy

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


PURPOSE Understanding individuals’ preferences for participating in health care decisions is foundational to delivering person-centered care. We aimed to (1) explore preferences for health care decision making among older adults, and (2) identify multimorbidity profiles associated with preferring less active, ie, passive, participation among older US adults. METHOD Ours was a cross-sectional, nationally representative study of 2,017 National Health and Aging Trends Study respondents. Passive decision-making preference was defined as preferring to leave decisions to physicians. Multimorbidity profiles, based on 13 prevalent chronic conditions, were examined as (1) presence of 2 or more conditions, (2) a simple conditions count, and (3) a condition clusters count. Multiple logistic regression was used with adjustment for age, sex, education, English proficiency, and mobility limitation. RESULTS Most older adults preferred to participate actively in making health care decisions. Older adults with 4 or more conditions, however, and those with multiple condition clusters are relatively less likely to prefer active decision making. CONCLUSIONS Primary care physicians should initiate a shared decision-making process with older adults with 4 or more conditions or multiple condition clusters. Physicians should anticipate variation in decision-making preferences among older adults and adapt a decision-making process that suits individuals’ preferences for participation to ensure person-centered care delivery.

Original languageEnglish (US)
Pages (from-to)546-551
Number of pages6
JournalAnnals of family medicine
Issue number6
StatePublished - Nov 1 2017


  • Multimorbidity
  • Patient engagement
  • Person-centered care
  • Shared decision making

ASJC Scopus subject areas

  • Family Practice


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