Prevalence of multimorbidity with frailty and associations with socioeconomic position in an adult population: findings from the cross-sectional HUNT Study in Norway

Abstract

ObjectivesTo explore prevalences and occupational group inequalities of two measures of multimorbidity with frailty.DesignCross-sectional study.SettingThe Nord-Trøndelag Health Study (HUNT), Norway, a total county population health survey, 2006–2008.ParticipantsParticipants older than 25 years, with complete questionnaires, measurements and occupation data were included.Outcomes≥2 of 51 multimorbid conditions with ≥1 of 4 frailty measures (poor health, mental illness, physical impairment or social impairment) and ≥3 of 51 multimorbid conditions with ≥2 of 4 frailty measures.AnalysisLogistic regression models with age and occupational group were specified for each sex separately.ResultsOf 41 193 adults, 38 027 (55% female; 25–100 years old) were included. Of them, 39% had ≥2 multimorbid conditions with ≥1 frailty measure, and 17% had ≥3 multimorbid conditions with ≥2 frailty measures. Prevalence differences in percentage points (pp) with 95% confidence intervals of those in high versus low occupational group with ≥2 multimorbid conditions and ≥1 frailty measure were largest in women age 30 years, 17 (14 to 20) pp and 55 years, 15 (13 to 17) pp and in men age 55 years, 15 (13 to 17) pp and 80 years, 14 (9 to 18) pp. In those with ≥3 multimorbid conditions and ≥2 frailty measures, prevalence differences were largest in women age 30 years, 8 (6 to 10) pp and 55 years, 10 (8 to 11) ppand in men age 55 years, 9 (8 to 11) pp and 80 years, 6 (95% CI 1 to 10) pp.ConclusionMultimorbidity with frailty is common, and social inequalities persist until age 80 years in women and throughout the lifespan in men. To manage complex multimorbidity, strategies for proportionate universalism in medical education, healthcare, public health prevention and promotion seem necessary.

Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study

“…We previously generated a set of 51 individual, chronic conditions from HUNT3 data [14,15] and further allocated those to body systems [14] by use of 14 chapters in the International Statistical Classification of Diseases 10th Revision (ICD-10) (supplementary data 1), hereafter called organ-grouped conditions.…”

“…Complex multimorbidity [20] and multimorbidity with frailty [34] are measures suggested to detect individuals in higher need of coordinated care which was previously operationalized in HUNT3 [14,15]. Organ-grouped disease counts were used in sensitivity analyses.…”

“…In Norway, previous studies on complex measures of multimorbidity, including frailty, reproduced increased prevalence in people in lower occupational groups, women, and older adults [14,15]. While the prevalence of multimorbidity and frailty rise with higher age, those younger than 65 years encompass a larger number of individuals with multimorbidity and frailty [15][16][17][18].…”

“…Still, in cross-sectional studies, acknowledged common determinants associated with multimorbidity and frailty are socioeconomic deprivation [8,12], female sex [8,13], and higher age [8,13]. In Norway, previous studies on complex measures of multimorbidity, including frailty, reproduced increased prevalence in people in lower occupational groups, women, and older adults [14,15]. While the prevalence of multimorbidity and frailty rise with higher age, those younger than 65 years encompass a larger number of individuals with multimorbidity and frailty [15][16][17][18].…”

Exercise interventions for older people at risk for frailty

“…[ 3 ] At present, there are different degrees of frailty among different elderly populations in various countries around the world. [ 4 , 5 ] Frailty and the risk of frailty are higher in older patients with more health problems, higher body mass indices, and reduced limb and leg strength. Vulnerability is more prevalent in women than in men.…”