Aging, obesity, and multimorbidity in women 50 years or older

Machado, Vânia Maria de Vasconcelos; Valadares, Ana Lúcia Ribeiro; Costa-Paiva, Lúcia; Osis, Maria José Duarte; Sousa, Maria Helena de; Pinto‐Neto, Aarão Mendes

doi:10.1097/gme.0b013e31827fdd8c

Cited by 43 publications

(37 citation statements)

References 29 publications

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“…8,10,15 Similar to several comparable studies, the ascertainment of diseases was based on self-reports. 19,20 The morbidities included cardiovascular diseases (CVDs), including hypertension, coronary heart disease and stroke, diabetes, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), liver disease, gastroesophageal reflux disease (GERD), tuberculosis, and cancers.…”

Section: Methodsmentioning

confidence: 99%

“…9,12,15,16 Because of the increasing importance of multimorbidity, we conducted a cross-sectional analysis of baseline data from the Golestan Cohort Study (GCS)—a large-scale study in a high incidence area of esophageal cancer in northern Iran 17 —to identify the prevalence and risk factors of multimorbidity in Iran as a middle-income country that may differ from those observed in developed countries.…”

Section: Introductionmentioning

confidence: 99%

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Multimorbidity

et al. 2016

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Advances in medicine and health policy have resulted in growing of older population, with a concurrent rise in multimorbidity, particularly in Iran, as a country transitioning to a western lifestyle, and in which the percent of the population over the age of 60 years is increasing. This study aims to assess multimorbidity and the associated risk factors in Iran.We used data from 50,045 participants (age 40–75 y) in the Golestan Cohort Study, including data on demographics, lifestyle habits, socioeconomic status, and anthropometric indices. Multimorbidity was defined as the presence of 2 or more out of 8 self-reported chronic conditions, including cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, liver disease, gastroesophageal reflux disease, tuberculosis, and cancer. Multivariate logistic regression models were used to examine the associations between multiple different factors and the risk factors.Multimorbidity prevalence was 19.4%, with the most common chronic diseases being gastroesophageal reflux disease (76.7%), cardiovascular diseases (72.7%), diabetes (25.3%), and chronic obstructive pulmonary disease (21.9%). The odds of multimorbidity was 2.56-fold higher at the age of >60 years compared with that at <50 years (P < 0.001), and 2.11-fold higher in women than in men (P < 0.001). Other factors associated with higher risk of multimorbidity included non-Turkmen ethnicity, low education, unemployment, low socioeconomic status, physical inactivity, overweight, obesity, former smoking, opium and alcohol use, and poor oral health.Apart from advanced age and female sex, the most important potentially modifiable lifestyle factors, including excess body weight and opium use, and opium user, are associated with multimorbidity. Policies aiming at controlling multimorbidity will require a multidimensional approach to reduce modifiable risk factors in the younger population in developing countries alongside adopting efficient strategies to improve life quality in the older population.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multimorbidity

et al. 2016

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“…[1][2][3] Multimorbidity is associated with a higher mortality risk and increased utilisation of healthcare services; therefore, it is a demanding situation for patients, their families and healthcare providers. [4][5][6][7][8] Despite the increase in life expectancy among lower and middle income countries over the last decades, the growing prevalence of multimorbidity has led to a decreased quality of life in patients with chronic diseases, especially in populations with limited resources. 9 10 Patients with multimorbidity require specific medical care; however, the current clinical practice lacks practical guidelines to manage and treat these patients.…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity as an important issue among women: results of a gender difference investigation in a large population-based cross-sectional study in West Asia

et al. 2017

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ObjectivesTo investigate the impact of gender on multimorbidity in northern Iran.DesignA cross-sectional analysis of the Golestan cohort data.SettingGolestan Province, Iran.Study population49 946 residents (age 40–75 years) of Golestan Province, Iran.Main outcome measuresResearchers collected data related to multimorbidity, defined as co-existence of two or more chronic diseases in an individual, at the beginning of a representative cohort study which recruited its participants from 2004 to 2008. The researchers utilised simple and multiple Poisson regression models with robust variances to examine the simultaneous effects of multiple factors.ResultsWomen had a 25.0% prevalence of multimorbidity, whereas men had a 13.4% prevalence (p<0.001). Women of all age-groups had a higher prevalence of multimorbidity. Of note, multimorbidity began at a lower age (40–49 years) in women (17.3%) compared with men (8.6%) of the same age (p<0.001). This study identified significant interactions between gender as well as socioeconomic status, ethnicity, physical activity, marital status, education level and smoking (p<0.01).ConclusionPrevention and control of multimorbidity requires health promotion programmes to increase public awareness about the modifiable risk factors, particularly among women.

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“…They showed that multimorbidity was associated with higher risk of death and readmission after hospital discharge, among elderly people. 24 It was also associated with aging and obesity and with worse self-perception of health among women; 25,26 and it was highly prevalent among elderly people using public primary healthcare services. 27 In addition, several methodological issues relating to studies on multimorbidity are still unresolved.…”

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confidence: 99%

Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis

2018

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BACKGROUND: Information about multimorbidity is scarce in developing countries. This study aimed to estimate the association of educational attainment with occurrences of multimorbidity in a population of public employees on university campuses in Rio de Janeiro. DESIGN AND SETTING: We conducted cross-sectional analyses on baseline data (1999-2001) from 3,253 participants in the Pró-Saúde study, conducted in Brazil. METHODS: The prevalence of multimorbidity, defined as a self-reported history of medical diagnoses of two or more chronic conditions, was estimated according to sex, age, smoking, obesity and educational level. The association between education and multimorbidity was estimated using odds ratios (OR) and the relative and slope indices of inequality, in order to quantify the degree of educational inequality among individuals with multimorbidity in this population. RESULTS: Greater age, female sex, smoking and obesity had direct associations with multimorbidity; and tobacco exposure and obesity also showed direct relationships with poorer educational level. There was a monotonic inverse linear trend between educational level and the presence of multimorbidity among women, with twice the odds (OR 2.47; 95% confidence interval, CI: 1.42-4.40) between extremities of schooling categories. There was excess multimorbidity of 22% at the lowest extremity of schooling, thus showing that women with worse educational status were more affected by the outcome. No trend and no excess multimorbidity was seen among men. CONCLUSIONS: Educational inequality is an important determinant for development of multimorbidity. Men and women experience its effect differently. Researchers need to consider that sex may be an effect modifier in multimorbidity studies.

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Aging, obesity, and multimorbidity in women 50 years or older

Abstract: Multimorbidity is principally associated with aging and obesity.

Cited by 43 publications

References 29 publications

Multimorbidity

Multimorbidity

Multimorbidity as an important issue among women: results of a gender difference investigation in a large population-based cross-sectional study in West Asia

Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis

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