Understanding the Evolution of Multimorbidity: Evidences from the North West Adelaide Health Longitudinal Study (NWAHS)

Abstract

ObjectiveThe aim of this study is to describe the evolution of multimorbidity.Study Design and SettingData from 1854 South Australians who participated in the North West Adelaide longitudinal Health Study(NWAHS) was collected between baseline (2000–2002) and follow-up (2008–2010). Status for eight chronic diseases (CDs) was determined by biomedical measurement or self-report. Chronic disease (CD) mean age of occurrence and order of appearance was investigated.ResultsThe prevalence of multimorbidity increased from 32% to 64% during the 7.8±1.1 years of follow-up. The estimated mean age of onset of a new CD was significantly older for hypertension, cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) and younger for hypercholesterolemia, asthma and other mental problem. Hypercholesterolemia was more likely to develop as a first than as a subsequent CD (39%vs.16%, p<0.0001) while CVD (1%vs.5%, p<0.0001), diabetes (5%vs.11%, p<0.001) and COPD (6%vs.16%, p<0.0001) were less likely. The presence of mood disorders at baseline was associated with an increased risk of developing other mental disorders (36%vs.12%, p<0.0001), diabetes (18%vs.9%, p<0.01) and asthma (30%vs.21%, p<0.05).ConclusionLongitudinal data could be used to study the evolution of multimorbidity and could provide information on CDs mean age of occurrence, order of appearance and impact on the development of future CDs.

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

“…This avoids the limitations of clinical, convenience or opportunistic samples and fills the knowledge gap associated with sampling elderly populations or sampling specific forms of arthritis populations [5, 6, 11, 15, 38, 41, 42]. Furthermore, by conducting exploratory analyses within the same population we are able to identify the variations in estimates attributable to the operational definitions and nominal thresholds used and not to differences in geographical setting, recruitment and data collection methods.…”

“…Conversely, sample populations drawn from those currently employed in the workforce potentially skew towards those in better health, underestimating prevalence [15]. Reliable estimates of population prevalence of multimorbidity that include musculoskeletal conditions are particularly lacking and in an Australian context, where research is limited to the elderly and/or patients consulting their general practitioner, or to healthier, currently-employed workplace-based samples [5, 6, 11, 13, 15, 38, 41, 42]. …”

Multimorbidity and Risk of Mild Cognitive Impairment

“…The risk of disability, functional decline, premature death, poor quality of life, polypharmacy, more medical consultations, more hospitalizations, longer hospital stays, greater use of emergency care, and higher healthcare costs are all greater in individuals with multimorbidity . Certain chronic conditions may also enhance the development of additional chronic conditions …”

“…1 Advances in the management of chronic conditions have resulted in slower disease progression and delayed mortality, resulting in an increase in the prevalence of multimorbidity. 3 The risk of disability, functional decline, premature death, poor quality of life, polypharmacy, more medical consultations, more hospitalizations, longer hospital stays, greater use of emergency care, and higher healthcare costs are all greater in individuals with multimorbidity. 1,4 Certain chronic conditions may also enhance the development of additional chronic conditions.…”

“…1,4 Certain chronic conditions may also enhance the development of additional chronic conditions. 3 With the growing number of individuals aged 65 and older in the United States and worldwide, the implications of the effect of multimorbidity on risk of age-related conditions such as mild cognitive impairment (MCI) and dementia are highly relevant for public health planning, allocation of resources, and development of strategies to reduce risk of these conditions. In particular, multimorbid-ity may contribute to greater risk of MCI, an important precursor to Alzheimer's disease and other dementias, [5][6][7][8] but the association has not been comprehensively investigated in a population-based setting.…”