Assessing the relationship between multimorbidity, psychosocial variables, and clinical outcomes among older adults living in rural Appalachia.

The objective of this study was to assess the relationship between multimorbidity, psychosocial variables, and clinical outcomes among older adults with type 2 diabetes (T2D) in rural Appalachia. Point-of-care clinical data (e.g. A1c, systolic blood pressure, diastolic blood pressure) and self-reported survey data, that includes psychosocial factors (e.g. distress, depressive symptoms, social support, perceived stress), chronic conditions, and sociodemographic variables were obtained from older adults living in rural Appalachia. Clinical data and psychosocial variables were treated as outcome variables, whereas the number of comorbid conditions was treated as the predictor variable. Stress was significantly associated with multimorbidity (β = 0.24, SE = 0.08, p = 0.01). However, T2D distress, social support, disability, and depression did not have statistically significant relationships with multimorbidity. Further research should assess the role of stress on psychosocial factors and clinical outcomes in rural-dwelling older adults.