Author Identifier

Robert U Newton

ORCID : 0000-0003-0302-6129

Document Type

Journal Article

Publication Title

BMC Public Health

Volume

21

Issue

1

Publisher

Springer

School

School of Medical and Health Sciences / Exercise Medicine Research Institute / Centre for Exercise and Sports Science Research

RAS ID

36914

Funders

Government of Western Australia Department of Health, Australian Government City of Busselton Busselton Population Medical Research Institute

Comments

Hunter, M. L., Knuiman, M. W., Musk, B. A. W., Hui, J., Murray, K., Beilby, J. P., ... & James, A. L. (2021). Prevalence and patterns of multimorbidity in Australian baby boomers: The Busselton healthy ageing study. BMC Public Health, 21, article 1539. https://doi.org/10.1186/s12889-021-11578-y

Abstract

Background and objective: Chronic medical conditions accumulate within individuals with age. However, knowledge concerning the trends, patterns and determinants of multimorbidity remains limited. This study assessed the prevalence and patterns of multimorbidity using extensive individual phenotyping in a general population of Australian middle-aged adults. Methods: Participants (n = 5029, 55% female), born between 1946 and 1964 and attending the cross-sectional phase of the Busselton Healthy Ageing Study (BHAS) between 2010 and 2015, were studied. Prevalence of 21 chronic conditions was estimated using clinical measurement, validated instrument scores and/or self-reported doctor-diagnosis. Non-random patterns of multimorbidity were explored using observed/expected (O/E) prevalence ratios and latent class analysis (LCA). Variables associated with numbers of conditions and class of multimorbidity were investigated. Results: The individual prevalence of 21 chronic conditions ranged from 2 to 54% and multimorbidity was common with 73% of the cohort having 2 or more chronic conditions. (mean ± SD 2.75 ± 1.84, median = 2.00, range 0–13). The prevalence of multimorbidity increased with age, obesity, physical inactivity, tobacco smoking and family history of asthma, diabetes, myocardial infarct or cancer. There were 13 pairs and 27 triplets of conditions identified with a prevalence > 1.5% and O/E > 1.5. Of the triplets, arthritis ( > 50%), bowel disease ( > 33%) and depression-anxiety ( > 33%) were observed most commonly. LCA modelling identified 4 statistically and clinically distinct classes of multimorbidity labelled as: 1) “Healthy” (70%) with average of 1.95 conditions; 2) “Respiratory and Atopy” (11%, 3.65 conditions); 3) “Non-cardiometabolic” (14%, 4.77 conditions), and 4) “Cardiometabolic” (5%, 6.32 conditions). Predictors of multimorbidity class membership differed between classes and differed from predictors of number of co-occurring conditions. Conclusion: Multimorbidity is common among middle-aged adults from a general population. Some conditions associated with ageing such as arthritis, bowel disease and depression-anxiety co-occur in clinically distinct patterns and at higher prevalence than expected by chance. These findings may inform further studies into shared biological and environmental causes of co-occurring conditions of ageing. Recognition of distinct patterns of multimorbidity may aid in a holistic approach to care management in individuals presenting with multiple chronic conditions, while also guiding health resource allocation in ageing populations.

DOI

10.1186/s12889-021-11578-y

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Research Themes

Health

Priority Areas

Exercise, nutrition, lifestyle and other interventions for optimal health across the lifespan

Included in

Public Health Commons

Share

 
COinS