Definitions and Prevalence of Multimorbidity in Large Database Studies: A Scoping Review

Chua, Ying Pin; Xie, Ying; Lee, Poay Sian Sabrina; Lee, Eng Sing

doi:10.3390/ijerph18041673

Cited by 42 publications

(36 citation statements)

References 46 publications

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“…Our results showed that 36.8% of the inpatients living in Chengdu during the 2015-2019 time period had at least two chronic diseases, which is lower than that in the Netherlands (multimorbidity prevalence of 57%) [ 39 ], Spain (multimorbidity prevalence of 43.2%) [ 40 ], and Canada (multimorbidity prevalence of 53.3%) [ 6 ], but higher than that in the United Kingdom (multimorbidity prevalence of 19%) [ 14 ], Scotland (multimorbidity prevalence of 31.1%) [ 41 ], Singapore (multimorbidity prevalence of 26.2%) [ 42 ], Italy (multimorbidity prevalence of 15.3%) [ 43 ], and Denmark (multimorbidity prevalence of 21.6%) [ 44 ]. A scoping review found a wide range in multimorbidity prevalence in the general population as reported in studies using a large data set, from 15.3% to 68.4% [ 45 ]. The reported multimorbidity prevalence is still highly varied due to inconsistent measurements of chronic conditions and multimorbidity [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…A scoping review found a wide range in multimorbidity prevalence in the general population as reported in studies using a large data set, from 15.3% to 68.4% [ 45 ]. The reported multimorbidity prevalence is still highly varied due to inconsistent measurements of chronic conditions and multimorbidity [ 45 , 46 ]. Additionally, a study using claims data in Beijing reported that the prevalence of multimorbidity was 51.6% and 81.3% for middle-aged adults (45-59 years) and older adults (≥60 years), respectively [ 47 ], which were higher than the respective prevalences of 41.7% and 75.2% in our study.…”

Section: Discussionmentioning

confidence: 99%

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Age- and Sex-Specific Differences in Multimorbidity Patterns and Temporal Trends on Assessing Hospital Discharge Records in Southwest China: Network-Based Study

Wang¹,

Qiu²,

Luo³

et al. 2022

J Med Internet Res

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Background Multimorbidity represents a global health challenge, which requires a more global understanding of multimorbidity patterns and trends. However, the majority of studies completed to date have often relied on self-reported conditions, and a simultaneous assessment of the entire spectrum of chronic disease co-occurrence, especially in developing regions, has not yet been performed. Objective We attempted to provide a multidimensional approach to understand the full spectrum of chronic disease co-occurrence among general inpatients in southwest China, in order to investigate multimorbidity patterns and temporal trends, and assess their age and sex differences. Methods We conducted a retrospective cohort analysis based on 8.8 million hospital discharge records of about 5.0 million individuals of all ages from 2015 to 2019 in a megacity in southwest China. We examined all chronic diagnoses using the ICD-10 (International Classification of Diseases, 10th revision) codes at 3 digits and focused on chronic diseases with ≥1% prevalence for each of the age and sex strata, which resulted in a total of 149 and 145 chronic diseases in males and females, respectively. We constructed multimorbidity networks in the general population based on sex and age, and used the cosine index to measure the co-occurrence of chronic diseases. Then, we divided the networks into communities and assessed their temporal trends. Results The results showed complex interactions among chronic diseases, with more intensive connections among males and inpatients ≥40 years old. A total of 9 chronic diseases were simultaneously classified as central diseases, hubs, and bursts in the multimorbidity networks. Among them, 5 diseases were common to both males and females, including hypertension, chronic ischemic heart disease, cerebral infarction, other cerebrovascular diseases, and atherosclerosis. The earliest leaps (degree leaps ≥6) appeared at a disorder of glycoprotein metabolism that happened at 25-29 years in males, about 15 years earlier than in females. The number of chronic diseases in the community increased over time, but the new entrants did not replace the root of the community. Conclusions Our multimorbidity network analysis identified specific differences in the co-occurrence of chronic diagnoses by sex and age, which could help in the design of clinical interventions for inpatient multimorbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Age- and Sex-Specific Differences in Multimorbidity Patterns and Temporal Trends on Assessing Hospital Discharge Records in Southwest China: Network-Based Study

Wang¹,

Qiu²,

Luo³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

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“…Because there is no uniform gold standard for measuring multimorbidity, prevalence depends on the number of chronic diseases studied or the population studied. From 2012 to 2019, the prevalence of chronic multimorbidity in the current population ranged from 15.3 to 93.1% [ 6 ]. However, it has long been noted that for older patients treated in ambulatory care settings, the criteria of three chronic diseases are considered more valid cut-off points for multimorbidity than the usual criteria of two chronic diseases [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Age, sex, residence, and region-specific differences in prevalence and patterns of multimorbidity among older Chinese: evidence from Chinese Longitudinal Healthy Longevity Survey

Han

Gao

et al. 2022

BMC Public Health

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Background Multimorbidity among older adults, which is associated with added functional decline and higher health care utilization and mortality, has become increasingly common with the dramatic acceleration of ageing in China. The purpose of this study was to reveal age, sex, residence, and region- specific prevalence and patterns of multimorbidity among older adults in China. Methods This study is based on the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS), the most recent edition of this national survey, and involved analysis of 15,275 participants aged 65 years and older. Multimorbidity was defined as an individual who has two or more chronic diseases or conditions and was divided into two types for analysis: ≥2 (MM2+) and ≥ 3 (MM3+). Fourteen chronic diseases or conditions surveyed were used to assess patterns of multimorbidity through association rule mining. Results Among the 15,275 participants, the largest proportion (39.9%) was 90 years old and over, while the distribution of sex and residence is roughly the same. Overall, the prevalence of multimorbidity was 44.1% for MM2+ and 22.9% for MM3+. The most frequently occurring patterns were two or three combinations between hypertension, cardiovascular diseases and affective disorders. Cardiovascular diseases combined with diabetes or dyslipidemia showed the most predominant association in different age groups. Moreover, the prevalence of the hypertension +diabetes pattern decreased with age. The strongest associations were found for the clustering of hypertension + cardiovascular diseases + respiratory diseases in males, however, among females it was the cardiovascular diseases + diabetes cluster. Cardiovascular diseases + rheumatoid arthritis + visual impairment was observed in urban areas and hypertension + cardiovascular diseases + affective disorders in rural areas. The most distinctive association rule in Northern China was {cardiovascular diseases, hypertension, visual impairment} = > {diabetes}. Respiratory disease was more prevalent in combination with other systemic disorders in Western China, and affective disorders in Southern China. Conclusions The prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity varied by age, sex, residence, and region. Future efforts are needed to identify possible prevention strategies and guidelines that consider differences in demographic characteristics of multimorbid patients to promote health in older adults.

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“…In the meta-analysis of multimorbidities, the chronic diseases included in the 20 literatures were classified and counted, among which the 11 diseases with the most inclusion were included in our study. Therefore, the conclusions of our study are considered reliable [ 22 ]. Jiayi Gu et al [ 23 ] in a survey of the prevalence of multimorbidity among the elderly in Chinese urban areas, found that the prevalence rate was 49.4%, which was similar to the results of this study.…”

Section: Discussionmentioning

confidence: 89%

Multimorbidity in the elderly in China based on the China Health and Retirement Longitudinal Study

et al. 2021

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This study aimed to investigate the spatial distribution and patterns of multimorbidity among the elderly in China. Data on the occurrence of 14 chronic diseases were collected for 9710 elderly participants in the 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Web graph, Apriori algorithm, age-adjusted Charlson comorbidity index (AAC), and Spatial autocorrelation were used to perform the multimorbidity analysis. The multimorbidity prevalence rate was estimated as 49.64% in the elderly in China. Three major multimorbidity patterns were identified: [Asthma/Chronic lungs diseases]: (Support (S) = 6.17%, Confidence (C) = 63.77%, Lift (L) = 5.15); [Asthma, Arthritis, or rheumatism/ Chronic lungs diseases]: (S = 3.12%, C = 64.03%, L = 5.17); [Dyslipidemia, Hypertension, Arthritis or rheumatism/Heart attack]: (S = 3.96%, C = 51.56, L = 2.69). Results of the AAC analysis showed that the more chronic diseases an elderly has, the lower is the 10-year survival rate (P < 0.001). Global spatial autocorrelation showed a positive spatial correlation distribution for the prevalence of the third multimorbidity pattern in China (P = 0.032). The status of chronic diseases and multimorbidity among the elderly with a spatial correlation is a significant health issue in China.

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Definitions and Prevalence of Multimorbidity in Large Database Studies: A Scoping Review

Cited by 42 publications

References 46 publications

Age- and Sex-Specific Differences in Multimorbidity Patterns and Temporal Trends on Assessing Hospital Discharge Records in Southwest China: Network-Based Study

Age- and Sex-Specific Differences in Multimorbidity Patterns and Temporal Trends on Assessing Hospital Discharge Records in Southwest China: Network-Based Study

Age, sex, residence, and region-specific differences in prevalence and patterns of multimorbidity among older Chinese: evidence from Chinese Longitudinal Healthy Longevity Survey

Multimorbidity in the elderly in China based on the China Health and Retirement Longitudinal Study

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