FUNCTIONAL STATE AND QUALITY OF LIFE OF GERIATRIC PATIENTS WITH CHRONIC NON-INFECTIOUS DISEASES IN CONDITIONS OF COMORBIDITY

DOI: 10.22138/2500-0918-2026-23-2-241-253

N.S. Vtorushin¹,², T.V. Bolotnova², A.D. Andreeva²

¹Center for Long-Term Care and Rehabilitation LLC, Yekaterinburg, Russia.

²Tyumen State Medical University, Ministry of Health of the Russian Federation

Abstract. Chronic non-communicable diseases and comorbidity are leading factors contributing to reduced functional independence and impaired quality of life in older and very old patients. A retrospective analysis of medical records of 110 patients of a geriatric center for the year 2025 was conducted. Comorbidity was assessed using the Charlson Comorbidity Index (Age-Adjusted CCI, ACCI) and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Functional status was evaluated using the Activities of Daily Living (ADL, Barthel Index), Instrumental Activities of Daily Living (IADL, Lawton Index), and the Timed Up-and-Go (TUG) test. Quality of life was assessed using the EQ-5D-3L questionnaire. The mean age of patients was 77.3 ± 6.4 years. A statistically significant association was found between increasing comorbidity burden and a decline in functional independence, mobility, and quality of life (p<0.05). The most pronounced functional impairments were observed in patients with a combination of cardiovascular disease, diabetes mellitus, and chronic obstructive pulmonary disease. A high prevalence of geriatric syndromes, including falls syndrome, sarcopenia, and malnutrition, was also noted. The findings confirm the need for comprehensive geriatric assessment, including evaluation of comorbidity, functional status, and quality of life, for timely risk stratification and development of personalized treatment and rehabilitation programs. Background. Chronic non-communicable diseases (NCDs) are the main cause of reduced functional independence and impaired quality of life in older adults. In the context of population ageing, the prevalence of comorbid conditions is increasing, significantly reducing patients’ quality of life and level of functional independence, and requiring a comprehensive clinical and functional approach to patient assessment and treatment strategy determination [1, 2]. Aim. To investigate quality of life and the level of functional independence in older and very old patients with chronic non-communicable diseases in the context of comorbidity. Materials and Methods. A retrospective analysis of medical records of older patients (n = 110) from a geriatric center for 2025 was performed. All patient data were anonymized; informed consent was obtained in accordance with institutional requirements. The structure of chronic diseases and the degree of comorbidity were assessed using the Charlson Comorbidity Index (Age-Adjusted CCI, ACCI). Functional status was evaluated using the Activities of Daily Living (ADL, Barthel Index), Instrumental Activities of Daily Living (IADL, Lawton Index), fall risk using the Timed Up-and-Go (TUG) test, and quality of life using the EQ-5D-3L questionnaire. Statistical analysis was performed using standard statistical software. Quantitative variables are presented as median and interquartile range (Me [Q1; Q3]), as most variables were not normally distributed. The Kruskal–Wallis test was used for group comparisons, and Spearman’s rank correlation coefficient was applied to assess the relationship between the ACCI comorbidity index and functional status indicators. The significance level was set at p<0.05. Results. The mean age of patients was 77.3 ± 6.4 years. The mean Age-Adjusted Charlson Comorbidity Index (ACCI) was 7.48 ± 1.3 points. A statistically significant deterioration in functional status, quality of life, and physical mobility was observed with increasing comorbidity burden (Kruskal–Wallis test, p<0.001). Spearman correlation analysis demonstrated a strong negative association between ACCI and Activities of Daily Living (ADL) scores (ρ = −0.863; p<0.001), Instrumental Activities of Daily Living (IADL) scores (ρ = −0.696; p<0.001), and quality of life measured by EQ-5D-3L (ρ = −0.842; p<0.001). A strong positive correlation was found between ACCI and TUG test completion time (ρ = 0.916; p<0.001), reflecting worsening mobility with increasing comorbidity. Conclusion. Comorbidity in older patients has a significant impact on functional status, physical activity, and quality of life. A comprehensive assessment of clinical and functional status enables more accurate risk stratification and optimization of diagnostic and therapeutic strategies in geriatric practice.
Abbreviations:
NCDs – Chronic non-communicable diseases
ADL – Activities of Daily Living
IADL – Instrumental Activities of Daily Living
ACCI – Age-Adjusted Charlson Comorbidity Index
CIRS-G – Cumulative Illness Rating Scale for Geriatrics
EQ-5D-3L – EuroQol 5-Dimension 3-Level questionnaire
TUG – Timed Up-and-Go test

Keywords: older adults, chronic non-communicable diseases, comorbidity, functional status, geriatrics

There is no conflict of interest.
Contact details of the corresponding author:
Nikita Sergeyevich Vtorushin
drelf7@gmail.com
Received: 25.05.2026

For citation: Vtorushin N.S., Bolotnova T.V., Andreeva A.D. Functional state and quality of life of geriatric patients with chronic non-infectious diseases in conditions of comorbidity [Online] Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2026, Vol. 23, no. 2, pp. 241–253. DOI: 10.22138/2500-0918-2026-23-2-241-253 (In Russ)

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Authors
Vtorushin Nikita S. 
Medical Director of LLC “Long-term Care and Rehabilitation Center”.
drelf7@gmail.com
Phone number +7(952)345-63-95
ORCID ID: 0009-0008-1756-0166
eLibrary SPIN: 3642-1659

Bolotnova Tatyana V.
Doctor of Medical Sciences, Professor, Honored Doctor of the Russian Federation, Chief freelance geriatrician of the Tyumen region, Head of the Department of Internal Medicine, Outpatient Therapy, and Family Medicine
Tyumen State Medical University
ORCID: 0000-0002-9776-5506
eLibrary SPIN: 9385-2839

Andreeva Anzhelika D.
Assistant Professor, Department of Internal Medicine, Outpatient Therapy, and Family Medicine
Tyumen State Medical University
ORCID: 0009-0006-7537-4877
eLibrary SPIN: 3264-5639