Cross-sectional examination of musculoskeletal conditions and multimorbidity: influence of different thresholds and definitions on prevalence and association estimates

Lowe, Dianne; Taylor, Michael J.; Hill, Sophie

doi:10.1186/s13104-017-2376-4

Cited by 15 publications

(21 citation statements)

References 51 publications

(93 reference statements)

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“…; Lowe et al . ), was low. There was also an absence of conditions related to alcohol dependence, which is a feature of other general population multimorbidity studies (McLean et al .…”

Section: Discussionmentioning

confidence: 86%

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Tyrer

Dunkley

Singh

et al. 2018

J intellect Disabil Res

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Background Multimorbidity [two or more conditions in addition to intellectual disability (ID)] is known to be more common among people with ID. However, the relationship between multimorbidity and lifestyle factors is currently unknown. The aim of this study was to determine the prevalence of multimorbidity in a population of adults with ID. We also aimed to identify risk factors, including lifestyle factors, for multimorbidity in this population. Methods This was a cross‐sectional analysis using data from a diabetes screening study of 920 adults aged 18–74 years with ID living in Leicestershire, UK. We described comorbidities and the prevalence of multimorbidity in this population. We explored the relationship between multimorbidity and age, gender, ethnicity, severity of ID, socio‐economic status, physical activity, sedentary behaviour, fruit and vegetable consumption and smoking status using multiple logistic regression. Results The prevalence of multimorbidity was 61.2% (95% CI 57.7–64.7). Multimorbidity was independently associated with being female (P < 0.001) and severe/profound ID (P = 0.004). Increasing age was of borderline significance (P = 0.06). Individuals who were physically inactive or sedentary were more likely to be multimorbid, independent of ability to walk, age, gender, severity of ID, ethnicity and socio‐economic status (adjusted OR = 1.91; 95% CI 1.23–2.97; P = 0.004 and OR = 1.98; 95% CI 1.42–2.77; P < 0.001). After excluding probable life‐long conditions (autism spectrum conditions, attention deficit hyperactivity disorders, epilepsy, cerebral palsy and other paralytic syndromes) as contributing comorbidities, the effect of sedentary behaviour, but not physical activity, remained (P = 0.004). We did not observe a relationship between multimorbidity, fruit and vegetable consumption and smoking status. Conclusions Multimorbidity presents a significant burden to people with ID. Individuals who were physically inactive or sedentary were more likely to be multimorbid, but further work is recommended to explore the relationship between multimorbidity and lifestyle factors using standardised objective measures.

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“…; Lowe et al . ), was low. There was also an absence of conditions related to alcohol dependence, which is a feature of other general population multimorbidity studies (McLean et al .…”

Section: Discussionmentioning

confidence: 86%

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Tyrer

Dunkley

Singh

et al. 2018

J intellect Disabil Res

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“…We have termed this the “policy definition” of multimorbidity [40, 41]. As there isn’t a gold standard for operationalising multimorbidity based on condition counts, we have previously examined three potential definitions.…”

Section: Discussionmentioning

confidence: 99%

“…As there isn’t a gold standard for operationalising multimorbidity based on condition counts, we have previously examined three potential definitions. While these definitions resulted in highly variable estimates of prevalence of multimorbidity [40], all definitions examined were similar in terms of associations with burden [41]. However, the policy definition was more strongly associated with distress [41].…”

Section: Discussionmentioning

confidence: 99%

“…All chronic conditions reported were then coded by the Australian Bureau of Statistics to a categorisation system based on the Tenth Revision of the International Classification of Diseases and Health Related Problems (ICD-10-AM). Further details on the specific diagnoses included in each condition category that contributed to multimorbidity are published elsewhere [40, 41]. …”

Section: Methodsmentioning

confidence: 99%

“…We previously examined the prevalence of and associations between multimorbidity and self-rated health or healthcare burden measures among working-age adults with any musculoskeletal condition when using three different ways of defining multimorbidity [40, 41]. Regardless of the definition used, multimorbidity was highly associated with the majority of the health burden measures within the combined musculoskeletal population [41].…”

Section: Introductionmentioning

confidence: 99%

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Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study

Lowe

Taylor

Hill

2017

BMC Musculoskelet Disord

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BackgroundMultiple health conditions are increasingly a problem for adults with musculoskeletal conditions. However, multimorbidity research has focused primarily on the elderly and those with a limited subset of musculoskeletal disorders. We sought to determine whether associations between multimorbidity and additional burden differ with specific forms of musculoskeletal conditions among working-age adults.MethodsData were sourced from a nationally representative Australian survey. Specific musculoskeletal conditions examined were osteoarthritis; inflammatory arthritis; other forms of arthritis or arthropathies; musculoskeletal conditions not elsewhere specified; gout; back pain; soft tissue disorders; or osteoporosis. Multimorbidity was defined as the additional presence of one or more of the Australian National Health Priority Area conditions. Burden was assessed by self-reported measures of: (i) self-rated health (ii) musculoskeletal-related healthcare and medicines utilisation and, (iii) general healthcare utilisation. Associations between multimorbidity and additional health or healthcare utilisation burden among working-age adults (aged 18 – 64 years of age) with specific musculoskeletal conditions were estimated using logistic regression, adjusting for confounders. Interaction terms were fitted to identify whether there were specific musculoskeletal conditions where multimorbidity was more strongly associated with poorer health or greater healthcare utilisation than in the remaining musculoskeletal group.ResultsAmong working-age adults, for each of the specified musculoskeletal conditions, multimorbidity was associated with similar, increased likelihood of additional self-rated health burden and certain types of healthcare utilisation. While there were differences in the relationships between multimorbidity and burden for each of the specific musculoskeletal conditions, no one specific musculoskeletal condition appeared to be consistently associated with greater additional health burden in the presence of multimorbidity across the majority of self-rated health burden and healthcare use measures.ConclusionsFor working-age people with any musculoskeletal conditions examined here, multimorbidity increases self-reported health and healthcare utilisation burden. As no one musculoskeletal condition appears consistently worse off in the presence of multimorbidity, there is a need to better understand and identify strategies that acknowledge and address the additional burden of concomitant conditions for working-age adults with a range of musculoskeletal conditions.

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The contribution of musculoskeletal disorders in multimorbidity: Implications for practice and policy

Duffield

Ellis

Goodson

et al. 2017

Best Practice & Research Clinical Rheumatology

121

107

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People frequently live for many years with multiple chronic conditions (multimorbidity) that impair health outcomes and are expensive to manage. Multimorbidity has been shown to reduce quality of life and increase mortality. People with multimorbidity also rely more heavily on health and care services and have poorer work outcomes. Musculoskeletal disorders (MSDs) are ubiquitous in multimorbidity because of their high prevalence, shared risk factors, and shared pathogenic processes amongst other long-term conditions. Additionally, these conditions significantly contribute to the total impact of multimorbidity, having been shown to reduce quality of life, increase work disability, and increase treatment burden and healthcare costs. For people living with multimorbidity, MSDs could impair the ability to cope and maintain health and independence, leading to precipitous physical and social decline. Recognition, by health professionals, policymakers, non-profit organisations, and research funders, of the impact of musculoskeletal health in multimorbidity is essential when planning support for people living with multimorbidity.

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Cross-sectional examination of musculoskeletal conditions and multimorbidity: influence of different thresholds and definitions on prevalence and association estimates

Cited by 15 publications

References 51 publications

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study

The contribution of musculoskeletal disorders in multimorbidity: Implications for practice and policy

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