Dataset Information

Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country.

ABSTRACT: Importance:Multimorbidity is a growing health care problem in aging societies and is strongly associated with epidemiologic characteristics and sociodemographic factors. Knowledge of these associations is important for the design of effective preventive and management strategies. Objectives:To determine the association between multimorbidity and sociodemographic factors (age, socioeconomic status [SES], sex, and race/ethnicity) and the association between mental health diseases and physical diseases, as well as their implications for the types and costs of health care use. Design, Setting, and Participants:This population-based cross-sectional study used deidentified Singapore Eastern Regional Health System data collected between January 1, 2012, and December 31, 2016. Patients who were alive as of January 1, 2016, and residing in the Regional Health System region in 2016 (N?=?1?181?024) were included. Patients who had no year of birth records (n?=?573), were born in 2017 (n?=?93), or died before January 1, 2016 (n?=?47?322), were excluded. Main Outcomes and Measures:Multimorbidity, age, sex, SES, mental health, race/ethnicity, and health care use. Results:In the study population of 1?181?024 individuals, the mean (SD) age was 39.6 (22.1) years, 51.2% were women, 70.1% were Chinese, 7.1% were Indian, 13.5% were Malayan, and 9.3% were other races/ethnicities. Multimorbidity, present in 26.2% of the population, was more prevalent in female (26.8%; 95% CI, 26.7%-26.9%) than in male (25.6%; 95% CI, 25.5%-25.7%) patients and among patients with low SES (41.6%) than those with high SES (20.1%). Mental health diseases were significantly more prevalent among individuals with low SES (5.2%; 95% CI, 5.1%-5.2%) than high SES (2.1%; 95% CI, 2.0%-2.1%; P?

SUBMITTER: Low LL

PROVIDER: S-EPMC6902794 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country.

Low Lian Leng LL Kwan Yu Heng YH Ko Michelle Shi Min MSM Yeam Cheng Teng CT Lee Vivian Shu Yi VSY Tan Wee Boon WB Thumboo Julian J

JAMA network open 20191101 11

<h4>Importance</h4>Multimorbidity is a growing health care problem in aging societies and is strongly associated with epidemiologic characteristics and sociodemographic factors. Knowledge of these associations is important for the design of effective preventive and management strategies.<h4>Objectives</h4>To determine the association between multimorbidity and sociodemographic factors (age, socioeconomic status [SES], sex, and race/ethnicity) and the association between mental health diseases an ...[more]

PMID: 31722030

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Project description:BackgroundLifestyle factors are widely recognized as modifiers and major risk factors for non-communicable diseases. Previous studies on the prevalence of multimorbidity in Portugal predict an unfavourable reality. The aim of the present study was to analyse 1) the prevalence of multimorbidity in Portugal and 2) the association of individuals' lifestyles and sociodemographic factors with multimorbidity.MethodsA cross-sectional, population-wide study was conducted on a representative sample of the general population of Portuguese adults aged ≥ 20 years. Categorical variables were described by their respective absolute and relative frequencies (n (%)). All variables with a p-value < 20% were included in the multiple logistic regression model. The variables were removed one by one in descending order of p-value (p) until the model contained only significant variables. The results are presented using the odds ratio and 95% confidence intervals. P-values < 5% were considered significant.ResultsThe prevalence of multimorbidity was 48.9% (n = 436), and the odds of multimorbidity increased 4% (p < 0.001) for each year of increase in age. Participants with reasonable general health status had higher odds of multimorbidity (Odds ratio (OR) = 3.04; p < 0.001), and those with poor or very poor general health status had even higher odds (OR = 9.14; p < 0.001). Compared to those who never smoked, participants who quit smoking ≥ 1 year presented an increase of 91% (p = 0.005) in the odds of multimorbidity. Individuals with no good-quality sleep, non-moderate screen time, or non-moderate stress level had higher odds of multimorbidity (OR = 1.98; OR = 1.88; OR = 2.22, respectively. p < 0.001).ConclusionsThis study presented a new approach to multimorbidity in Portugal. Population-based, multidimensional lifestyle interventions are needed. It seems necessary to optimize and adjust measures to prevent non-communicable diseases to improve health in Portugal. In the future, longitudinal studies will be an asset to reinforce and clarify these conclusions.

Project description:ObjectiveTo study the social determinants and cardiovascular risk factors for multimorbidity and the acquisition sequence of multimorbidity.DesignLongitudinal study based on anonymised primary care data.SettingGeneral practices in an urban multiethnic borough in London, UK.Participants332 353 patients aged ≥18 years.Main outcome measuresClinical and sociodemographic characteristics of patients with multimorbidity, defined as ≥3 of 12 long-term conditions (LTCs) selected according to high predicted healthcare use. Multilevel logistic regression was used to model social determinants and cardiovascular risk factors. Alluvial plots were constructed to illustrate multimorbidity acquisition sequences according to age, ethnicity and social deprivation.Results5597 (1.7%) patients had ≥3 selected LTCs, the 'multimorbidity cohort'. The the most common LTCs were diabetes (63.0%) and chronic pain (CP) (42.8%). Social deprivation and ethnicity were independent determinants of multimorbidity: most compared with the least deprived quintile (adjusted OR (AOR) 1.56 (95% CI 1.41 to 1.72)); South Asian compared with white ethnicity (AOR 1.44 (95% CI 1.29 to 1.61)); and black compared with white ethnicity (AOR 0.86 (95% CI 0.80 to 0.92)). The included cardiovascular risk factors were relatively strong determinants of multimorbidity: hypertension (AOR 5.05 (95% CI 4.69 to 5.44)), moderate obesity (AOR 3.41 (95% CI 3.21 to 3.63)) and smoking (AOR 2.30 (95% CI 2.16 to 2.45)). The most common initial onset conditions were diabetes and depression; diabetes particularly in older and black ethnic groups; and depression particularly in younger, more deprived and white ethnicity groups. CP was less common as an initial condition.ConclusionOur findings confirm the importance of age, social deprivation and ethnicity as determinants of multimorbidity. Smoking, obesity and hypertension as cardiovascular risk factors were stronger determinants of multimorbidity than deprivation or ethnicity. The acquisition sequence of multimorbidity is patterned by sociodemographic determinants. Understanding onset conditions of multimorbidity and cardiovascular cardiovascular risk factors may lead to the development of interventions to slow the progression of multimorbidity.

Dataset Information

Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country.

Publications

Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country.

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