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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Multimorbidity prevalence and patterns across socioeconomic determinants: a cross-sectional survey

Authors: Calypse B Agborsangaya, Darren Lau, Markus Lahtinen, Tim Cooke, Jeffrey A Johnson

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Studies on the prevalence of multimorbidity, defined as having two or more chronic conditions, have predominantly focused on the elderly. We estimated the prevalence and specific patterns of multimorbidity across different adult age groups. Furthermore, we examined the associations of multimorbidity with socio-demographic factors.

Methods

Using data from the Health Quality Council of Alberta (HQCA) 2010 Patient Experience Survey, the prevalence of self reported multimorbidity was assessed by telephone interview among a sample of 5010 adults (18 years and over) from the general population. Logistic regression analyses were performed to determine the association between a range of socio-demographic factors and multimorbidity.

Results

The overall age- and sex-standardized prevalence of multimorbidity was 19.0% in the surveyed general population. Of those with multimorbidity, 70.2% were aged less than 65 years. The most common pairing of chronic conditions was chronic pain and arthritis. Age, sex, income and family structure were independently associated with multimorbidity.

Conclusions

Multimorbidity is a common occurrence in the general adult population, and is not limited to the elderly. Future prevention programs and practice guidelines should take into account the common patterns of multimorbidity.
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Literature
1.
go back to reference Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L: Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005, 3 (3): 223-228. 10.1370/afm.272.CrossRefPubMedPubMedCentral Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L: Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005, 3 (3): 223-228. 10.1370/afm.272.CrossRefPubMedPubMedCentral
2.
go back to reference Starfield B: Challenges to primary care from co- and multi-morbidity. Prim Health Care Res & Dev. 2011, 12 (1): 1-2.CrossRef Starfield B: Challenges to primary care from co- and multi-morbidity. Prim Health Care Res & Dev. 2011, 12 (1): 1-2.CrossRef
3.
go back to reference Dawes M: Co-morbidity: we need a guideline for each patient not a guideline for each disease. Fam Pract. 2010, 27 (1): 2-CrossRef Dawes M: Co-morbidity: we need a guideline for each patient not a guideline for each disease. Fam Pract. 2010, 27 (1): 2-CrossRef
4.
go back to reference Bayliss EF, Edwards AE, Steiner JF, Main DS: Processes of care desired by elderly patients with multimorbidities. Fam Pract. 2008, 25 (4): 287-93. 10.1093/fampra/cmn040.CrossRefPubMedPubMedCentral Bayliss EF, Edwards AE, Steiner JF, Main DS: Processes of care desired by elderly patients with multimorbidities. Fam Pract. 2008, 25 (4): 287-93. 10.1093/fampra/cmn040.CrossRefPubMedPubMedCentral
5.
go back to reference Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D: Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med. 2007, 22 (Suppl 3): 391-395.CrossRefPubMedPubMedCentral Vogeli C, Shields AE, Lee TA, Gibson TB, Marder WD, Weiss KB, Blumenthal D: Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med. 2007, 22 (Suppl 3): 391-395.CrossRefPubMedPubMedCentral
6.
go back to reference Condelius A, Edberg AK, Jakobsson U, Hallberg IR: Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Arch Gerontol Geriatr. 2008, 46 (1): 41-55. 10.1016/j.archger.2007.02.005.CrossRefPubMed Condelius A, Edberg AK, Jakobsson U, Hallberg IR: Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Arch Gerontol Geriatr. 2008, 46 (1): 41-55. 10.1016/j.archger.2007.02.005.CrossRefPubMed
7.
go back to reference van den Akker M, Buntinx F, Roos S, Knottnerus JA: Problems in determining occurrence rates of multimorbidity. J Clin Epidemiol. 2001, 54 (7): 675-679. 10.1016/S0895-4356(00)00358-9.CrossRefPubMed van den Akker M, Buntinx F, Roos S, Knottnerus JA: Problems in determining occurrence rates of multimorbidity. J Clin Epidemiol. 2001, 54 (7): 675-679. 10.1016/S0895-4356(00)00358-9.CrossRefPubMed
8.
go back to reference Valderas JM, Starfield B, Roland M: Multimorbidity's many challenges: a research priority in the UK. BMJ. 2007, 334 (7604): 1016-7.CrossRef Valderas JM, Starfield B, Roland M: Multimorbidity's many challenges: a research priority in the UK. BMJ. 2007, 334 (7604): 1016-7.CrossRef
9.
go back to reference Clottey C, Mo F, LeBrun B, Mickelson P, Niles J, Robbins G: The development of the National Diabetes Surveillance System (NDSS) in Canada. Chronic Dis Can. 2001, 22 (2): 67-9.PubMed Clottey C, Mo F, LeBrun B, Mickelson P, Niles J, Robbins G: The development of the National Diabetes Surveillance System (NDSS) in Canada. Chronic Dis Can. 2001, 22 (2): 67-9.PubMed
10.
go back to reference Johnson JA, Balko SU: Epidemiological Trends of Diabetes in Alberta. 2009, Edmonton: Institute of Health Economics Johnson JA, Balko SU: Epidemiological Trends of Diabetes in Alberta. 2009, Edmonton: Institute of Health Economics
11.
go back to reference Taylor AW, Price K, Gill TK, Adams R, Pilkington R, Carrangis N, Shi Z, Wilson D: Multimorbidity-not just an older person's issue. Results from an Australian biomedical study. BMC Publ Health. 2010, 10: 718-10.1186/1471-2458-10-718.CrossRef Taylor AW, Price K, Gill TK, Adams R, Pilkington R, Carrangis N, Shi Z, Wilson D: Multimorbidity-not just an older person's issue. Results from an Australian biomedical study. BMC Publ Health. 2010, 10: 718-10.1186/1471-2458-10-718.CrossRef
12.
go back to reference Britt HC, Harrison CM, Miller GC, Knox SA: Prevalence and patterns of multimorbidity in Australia. Med J Aust. 2008, 189 (2): 72-77.PubMed Britt HC, Harrison CM, Miller GC, Knox SA: Prevalence and patterns of multimorbidity in Australia. Med J Aust. 2008, 189 (2): 72-77.PubMed
13.
go back to reference Akner G: Analysis of multimorbidity in individual elderly nursing home residents. Development of a multimorbidity matrix. Arch Gerontol Geriatr. 2009, 49 (3): 413-419. 10.1016/j.archger.2008.12.009.CrossRefPubMed Akner G: Analysis of multimorbidity in individual elderly nursing home residents. Development of a multimorbidity matrix. Arch Gerontol Geriatr. 2009, 49 (3): 413-419. 10.1016/j.archger.2008.12.009.CrossRefPubMed
14.
go back to reference Fortin M, Lapointe L, Hudon C, Vanasse A: Multimorbidity is common to family practice: is it commonly researched?. Can Fam Physician. 2005, 51: 244-245.PubMed Fortin M, Lapointe L, Hudon C, Vanasse A: Multimorbidity is common to family practice: is it commonly researched?. Can Fam Physician. 2005, 51: 244-245.PubMed
15.
go back to reference Mercer SW, Smith SM, Wyke S, O'Dowd T, Watt GC: Multimorbidity in primary care: developing the research agenda. Fam Pract. 2009, 26 (2): 79-80. 10.1093/fampra/cmp020.CrossRefPubMed Mercer SW, Smith SM, Wyke S, O'Dowd T, Watt GC: Multimorbidity in primary care: developing the research agenda. Fam Pract. 2009, 26 (2): 79-80. 10.1093/fampra/cmp020.CrossRefPubMed
16.
go back to reference Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA: Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. British J Gen Pract. 2011, 61 (582): e12-e21. 10.3399/bjgp11X548929.CrossRef Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA: Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. British J Gen Pract. 2011, 61 (582): e12-e21. 10.3399/bjgp11X548929.CrossRef
17.
go back to reference Mercer SW, Watt GC: The inverse care law: clinical primary care encounters in deprived and affluent areas of Scotland. Ann Fam Med. 2007, 5 (6): 503-510. 10.1370/afm.778.CrossRefPubMedPubMedCentral Mercer SW, Watt GC: The inverse care law: clinical primary care encounters in deprived and affluent areas of Scotland. Ann Fam Med. 2007, 5 (6): 503-510. 10.1370/afm.778.CrossRefPubMedPubMedCentral
18.
go back to reference Ekundayo OJ, Muchimba M, Aban IB, Ritchie C, Campbell RC, Ahmed A: Multimorbidity due to diabetes mellitus and chronic kidney disease and outcomes in chronic heart failure. Am J Cardiol. 2009, 103 (1): 88-92. 10.1016/j.amjcard.2008.08.035.CrossRefPubMed Ekundayo OJ, Muchimba M, Aban IB, Ritchie C, Campbell RC, Ahmed A: Multimorbidity due to diabetes mellitus and chronic kidney disease and outcomes in chronic heart failure. Am J Cardiol. 2009, 103 (1): 88-92. 10.1016/j.amjcard.2008.08.035.CrossRefPubMed
19.
go back to reference Glynn LG, Buckley B, Reddan D, Newell J, Hinde J, Dinneen SF, Murphy AW: Multimorbidity and risk among patients with established cardiovascular disease: a cohort study. British J Gen Pract. 2008, 58 (552): 488-494. 10.3399/bjgp08X319459.CrossRef Glynn LG, Buckley B, Reddan D, Newell J, Hinde J, Dinneen SF, Murphy AW: Multimorbidity and risk among patients with established cardiovascular disease: a cohort study. British J Gen Pract. 2008, 58 (552): 488-494. 10.3399/bjgp08X319459.CrossRef
20.
go back to reference Gross CP, Guo Z, McAvay GJ, Allore HG, Young M, Tinetti ME: Multimorbidity and survival in older persons with colorectal cancer. J Am Geriatr Soc. 2006, 54 (12): 1898-1904. 10.1111/j.1532-5415.2006.00973.x.CrossRefPubMed Gross CP, Guo Z, McAvay GJ, Allore HG, Young M, Tinetti ME: Multimorbidity and survival in older persons with colorectal cancer. J Am Geriatr Soc. 2006, 54 (12): 1898-1904. 10.1111/j.1532-5415.2006.00973.x.CrossRefPubMed
21.
go back to reference Lanzer P: Vascular multimorbidity in patients with a documented coronary artery disease. Z Kardiol. 2003, 92 (8): 650-659. 10.1007/s00392-003-0954-z.CrossRefPubMed Lanzer P: Vascular multimorbidity in patients with a documented coronary artery disease. Z Kardiol. 2003, 92 (8): 650-659. 10.1007/s00392-003-0954-z.CrossRefPubMed
22.
go back to reference Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L: Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc. 2009, 57 (2): 225-230. 10.1111/j.1532-5415.2008.02109.x.CrossRefPubMed Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L: Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc. 2009, 57 (2): 225-230. 10.1111/j.1532-5415.2008.02109.x.CrossRefPubMed
23.
go back to reference Marengoni A, Winblad B, Karp A, Fratiglioni L: Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. Am J Public Health. 2008, 98 (7): 1198-1200. 10.2105/AJPH.2007.121137.CrossRefPubMedPubMedCentral Marengoni A, Winblad B, Karp A, Fratiglioni L: Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. Am J Public Health. 2008, 98 (7): 1198-1200. 10.2105/AJPH.2007.121137.CrossRefPubMedPubMedCentral
24.
go back to reference Menotti A, Mulder I, Nissinen A, Giampaoli S, Feskens EJ, Kromhout D: Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: The FINE study (Finland, Italy, Netherlands, Elderly). J Clin Epidemiol. 2001, 54 (7): 680-686. 10.1016/S0895-4356(00)00368-1.CrossRefPubMed Menotti A, Mulder I, Nissinen A, Giampaoli S, Feskens EJ, Kromhout D: Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: The FINE study (Finland, Italy, Netherlands, Elderly). J Clin Epidemiol. 2001, 54 (7): 680-686. 10.1016/S0895-4356(00)00368-1.CrossRefPubMed
25.
go back to reference Schafer I, von Leitner EC, Schon G, Koller D, Hansen H, Kolonko T, Kaduszkiewicz H, Wegscheider K, Glaeske G, van den Bussche H: Multimorbidity patterns in the elderly: a new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS One. 2010, 5 (12): e15941-10.1371/journal.pone.0015941.CrossRefPubMedPubMedCentral Schafer I, von Leitner EC, Schon G, Koller D, Hansen H, Kolonko T, Kaduszkiewicz H, Wegscheider K, Glaeske G, van den Bussche H: Multimorbidity patterns in the elderly: a new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS One. 2010, 5 (12): e15941-10.1371/journal.pone.0015941.CrossRefPubMedPubMedCentral
26.
go back to reference Fortin M, Hudon C, Haggerty J, Akker M, Almirall J: Prevalence estimates of multimorbidity: a comparative study of two sources. BMC Health Serv Res. 2010, 10: 111-10.1186/1472-6963-10-111.CrossRefPubMedPubMedCentral Fortin M, Hudon C, Haggerty J, Akker M, Almirall J: Prevalence estimates of multimorbidity: a comparative study of two sources. BMC Health Serv Res. 2010, 10: 111-10.1186/1472-6963-10-111.CrossRefPubMedPubMedCentral
27.
go back to reference HQCA: Satisfaction and Experience with Health Care Services: A Survey of Albertans. 2010, Calgary: Health Quality Council of Alberta HQCA: Satisfaction and Experience with Health Care Services: A Survey of Albertans. 2010, Calgary: Health Quality Council of Alberta
28.
go back to reference van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA: Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998, 51 (5): 367-375. 10.1016/S0895-4356(97)00306-5.CrossRefPubMed van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA: Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998, 51 (5): 367-375. 10.1016/S0895-4356(97)00306-5.CrossRefPubMed
29.
go back to reference Akner G: Frail aging and multimorbidity affect more and more. Focus must be moved from isolated diseases to complex health problems]. Lakartidningen. 2010, 107 (44): 2707-2711.PubMed Akner G: Frail aging and multimorbidity affect more and more. Focus must be moved from isolated diseases to complex health problems]. Lakartidningen. 2010, 107 (44): 2707-2711.PubMed
30.
go back to reference Marengoni A, von Strauss E, Rizzuto D, Winblad B, Fratiglioni L: The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons. A community-based, longitudinal study. J Intern M. 2009, 265 (2): 288-295. 10.1111/j.1365-2796.2008.02017.x.CrossRef Marengoni A, von Strauss E, Rizzuto D, Winblad B, Fratiglioni L: The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons. A community-based, longitudinal study. J Intern M. 2009, 265 (2): 288-295. 10.1111/j.1365-2796.2008.02017.x.CrossRef
31.
go back to reference Nagel G, Peter R, Braig S, Hermann S, Rohrmann S, Linseisen J: The impact of education on risk factors and the occurrence of multimorbidity in the EPIC-Heidelberg cohort. BMC Publ Health. 2008, 8: 384-10.1186/1471-2458-8-384.CrossRef Nagel G, Peter R, Braig S, Hermann S, Rohrmann S, Linseisen J: The impact of education on risk factors and the occurrence of multimorbidity in the EPIC-Heidelberg cohort. BMC Publ Health. 2008, 8: 384-10.1186/1471-2458-8-384.CrossRef
32.
go back to reference Cynthia M, Boyd MF: Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design. Public Health Rev. 2010, 32 (2): 23- Cynthia M, Boyd MF: Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design. Public Health Rev. 2010, 32 (2): 23-
33.
go back to reference Rosland AM, Heisler M, Choi HJ, Silveira MJ, Piette JD: Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help?. Chronic Illn. 2010, 6 (1): 22-33. 10.1177/1742395309354608.CrossRefPubMedPubMedCentral Rosland AM, Heisler M, Choi HJ, Silveira MJ, Piette JD: Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help?. Chronic Illn. 2010, 6 (1): 22-33. 10.1177/1742395309354608.CrossRefPubMedPubMedCentral
34.
go back to reference Wolff Jl, Roter DL: Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Arch Intern Med. 2008, 168 (13): 1409-1415. 10.1001/archinte.168.13.1409.CrossRefPubMed Wolff Jl, Roter DL: Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Arch Intern Med. 2008, 168 (13): 1409-1415. 10.1001/archinte.168.13.1409.CrossRefPubMed
35.
go back to reference Diederichs C, Berger K, Bartels DB: The measurement of multiple chronic diseases-a systematic review on existing multimorbidity indices. The journals of gerontologySeries A, Biological sciences and medical sciences. 2011, 66 (3): 301-311.CrossRef Diederichs C, Berger K, Bartels DB: The measurement of multiple chronic diseases-a systematic review on existing multimorbidity indices. The journals of gerontologySeries A, Biological sciences and medical sciences. 2011, 66 (3): 301-311.CrossRef
36.
go back to reference The Italian Longitudinal Study on Aging Working G: Prevalence of chronic diseases in older Italians: comparing self-reported and clinical diagnoses. The Italian Longitudinal Study on Aging Working Group. Int J Epidemiol. 1997, 26 (5): 995-1002.CrossRef The Italian Longitudinal Study on Aging Working G: Prevalence of chronic diseases in older Italians: comparing self-reported and clinical diagnoses. The Italian Longitudinal Study on Aging Working Group. Int J Epidemiol. 1997, 26 (5): 995-1002.CrossRef
37.
go back to reference Gross R, Bentur N, Elhayany A, Sherf M, Epstein L: The validity of self-reports on chronic disease: characteristics of underreporters and implications for the planning of services. Public Health Rev. 1996, 24 (2): 167-82.PubMed Gross R, Bentur N, Elhayany A, Sherf M, Epstein L: The validity of self-reports on chronic disease: characteristics of underreporters and implications for the planning of services. Public Health Rev. 1996, 24 (2): 167-82.PubMed
38.
go back to reference de Groot V, Beckerman H, Lankhorst GJ, Bouter LM: How to measure comorbidity. a critical review of available methods. J Clin Epidemiol. 2003, 56 (3): 221-229. 10.1016/S0895-4356(02)00585-1.CrossRefPubMed de Groot V, Beckerman H, Lankhorst GJ, Bouter LM: How to measure comorbidity. a critical review of available methods. J Clin Epidemiol. 2003, 56 (3): 221-229. 10.1016/S0895-4356(02)00585-1.CrossRefPubMed
39.
go back to reference Starfield B: Global health, equity, and primary care. J Am Board Fam Med. 2007, 20 (6): 511-513. 10.3122/jabfm.2007.06.070176.CrossRefPubMed Starfield B: Global health, equity, and primary care. J Am Board Fam Med. 2007, 20 (6): 511-513. 10.3122/jabfm.2007.06.070176.CrossRefPubMed
Metadata
Title
Multimorbidity prevalence and patterns across socioeconomic determinants: a cross-sectional survey
Authors
Calypse B Agborsangaya
Darren Lau
Markus Lahtinen
Tim Cooke
Jeffrey A Johnson
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-201

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