Background In Southeast Asia, the prevalence of multimorbidity is gradually increasing. This paper aimed to investigate the association between educational level and multimorbidity among over 15-years old adults in Southeast Asia. Methods We conducted a systematic review of published observational studies. Studies were selected according to eligibility criteria of addressing definition and prevalence of multimorbidity and associations between level of education and multimorbidity in Southeast Asia. The Newcastle-Ottawa Scale (NOS) was used to measure the quality and risk of bias. The methodology has been published in PROSPERO with registered number ID: CRD42021259311. Results Eighteen studies were included in the data synthesis. The results are presented using narrative synthesis due to the heterogeneity of differences in exposures, outcomes, and methodology. The prevalence of multimorbidity ranged from 1.7% to 72.6% among over 18 years-old adults and from 1.5% to 51.5% among older people (≥ 60 years). There were three association patterns linking between multimorbidity and education in these studies: (1) higher education reducing odds of multimorbidity, (2) higher education increasing odds of multimorbidity and (3) education having no association with multimorbidity. The association between educational attainment and multimorbidity also varies widely across countries. In Singapore, three cross-sectional studies showed that education had no association with multimorbidity among adults. However, in Indonesia, four cross-sectional studies found higher educated persons to have higher odds of multimorbidity among over 40-years-old persons. Conclusions Published studies have shown inconsistent associations between education and multimorbidity because of different national contexts and the lack of relevant research in the region concerned. Enhancing objective data collection such as physical examinations would be necessary for studies of the connection between multimorbidity and education. It can be hypothesised that more empirical research would reveal that a sound educational system can help people prevent multimorbidity.

BACKGROUND: Due to economic and social development in Thailand, cardiovascular disease (CVD) and cerebrovascular disease (CVA) have been gradually replacing infectious diseases and have become the main threat to health in this country. METHOD: This study used the 2005 baseline data of 42785 members of the Thai cohort study (TCS) to identify health risk factors correlated with incidence of CVD and/or CVA over 8 years (2005- 2013). We applied multivariate logistic regression to investigate associations between demographic and socioeconomic factors, health conditions, and personal lifestyle factors and CVD and/or CVA incidence. RESULTS: The cumulative incidence of CVD and/or CVA in males was more than three times that in females. CVD and/or CVA incidence was correlated with ageing, obesity (AOR: 1.67, 95% CI: 1.16-2.40) and previous diagnosis with diabetes (AOR: 3.09, 95% CI: 1.80-5.30), hyperlipidaemia (AOR: 1.54, 95% CI: 1.08-2.19), hypertension (AOR: 1.71, 95% CI: 1.13-2.59), chronic kidney disease (AOR: 2.35, 95% CI: 1.35-4.10), and depression/anxiety (AOR: 2.76, 95% CI: 1.64-4.63). Short sleep time was positively associated with CVD and/or CVA in the Thai Cohort Study. An inverse association between performing housework and the incidence of CVD and/or CVA was also identified. However, current smoking had a significant positive correlation with the incidence of CVD and/or CVA for participants. CONCLUSION: Older age, obesity, underlying diseases, short sleep time, and current smoking were the risk factors for CVD and/or CVA incidence for the participants. However, housework, as an incidental exercise, could protect people against the risk of CVD and/or CVA.

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