TY - JOUR
T1 - Age, sex, and socioeconomic differences in multimorbidity measured in four ways
T2 - UK primary care cross-sectional analysis
AU - MacRae, Clare
AU - Mercer, Stewart W.
AU - Henderson, David
AU - McMinn, Megan
AU - Morales, Daniel R.
AU - Jefferson, Emily
AU - Lyons, Ronan A.
AU - Lyons, Jane
AU - Dibben, Chris
AU - McAllister, David A.
AU - Guthrie, Bruce
N1 - Funding Information:
Bruce Guthrie, Stewart W Mercer, Daniel R Morales, and Emily Jefferson received funding for this study from the Chief Scientist Office (reference: HIPS/18/30). Clare MacRae received funding for this study from an NHS Education for Scotland Academic Fellowship and Medical Research Council fellowship (reference: MR/W000253/1). The funders had no role in the development of study design, data collection and interpretation, or writing of the final report. The corresponding author had full data access and had final responsibility for submitting for publication.
Copyright:
© 2023 The Authors.
PY - 2023/4
Y1 - 2023/4
N2 - Background: Multimorbidity poses major challenges to healthcare systems worldwide. Definitions with cut-offs in excess of ≥2 long-term conditions (LTCs) might better capture populations with complexity but are not standardised.Aim: To examine variation in prevalence using different definitions of multimorbidity.Design and Setting: Cross-sectional study of 1 168 620 people in England.Method: Comparison of multimorbidity (MM) prevalence using four definitions: MM2+ (≥2 LTCs), MM3+ (≥3 LTCs), MM3+ from 3+ (≥3 LTCs from ≥3 International Classification of Diseases, 10th revision chapters), and mental-physical MM (≥2 LTCs where ≥1 mental health LTC and ≥1 physical health LTC are recorded). Logistic regression was used to examine patient characteristics associated with multimorbidity under all four definitions.Results: MM2+ was most common (40.4%) followed by MM3+ (27.5%), MM3+ from 3+ (22.6%), and mental-physical MM (18.9%). MM2+, MM3+, and MM3+ from 3+ were strongly associated with oldest age (adjusted odds ratio [aOR] 58.09, 95% confidence interval [CI] = 56.13 to 60.14; aOR 77.69, 95% CI = 75.33 to 80.12; and aOR 102.06, 95% CI = 98.61 to 105.65; respectively), but mental-physical MM was much less strongly associated (aOR 4.32, 95% CI = 4.21 to 4.43). People in the most deprived decile had equivalent rates of multimorbidity at a younger age than those in the least deprived decile. This was most marked in mental-physical MM at 40-45 years younger, followed by MM2+ at 15-20 years younger, and MM3+ and MM3+ from 3+ at 10-15 years younger. Females had higher prevalence of multimorbidity under all definitions, which was most marked for mental-physical MM.Conclusion: Estimated prevalence of multimorbidity depends on the definition used, and associations with age, sex, and socioeconomic position vary between definitions. Applicable multimorbidity research requires consistency of definitions across studies.
AB - Background: Multimorbidity poses major challenges to healthcare systems worldwide. Definitions with cut-offs in excess of ≥2 long-term conditions (LTCs) might better capture populations with complexity but are not standardised.Aim: To examine variation in prevalence using different definitions of multimorbidity.Design and Setting: Cross-sectional study of 1 168 620 people in England.Method: Comparison of multimorbidity (MM) prevalence using four definitions: MM2+ (≥2 LTCs), MM3+ (≥3 LTCs), MM3+ from 3+ (≥3 LTCs from ≥3 International Classification of Diseases, 10th revision chapters), and mental-physical MM (≥2 LTCs where ≥1 mental health LTC and ≥1 physical health LTC are recorded). Logistic regression was used to examine patient characteristics associated with multimorbidity under all four definitions.Results: MM2+ was most common (40.4%) followed by MM3+ (27.5%), MM3+ from 3+ (22.6%), and mental-physical MM (18.9%). MM2+, MM3+, and MM3+ from 3+ were strongly associated with oldest age (adjusted odds ratio [aOR] 58.09, 95% confidence interval [CI] = 56.13 to 60.14; aOR 77.69, 95% CI = 75.33 to 80.12; and aOR 102.06, 95% CI = 98.61 to 105.65; respectively), but mental-physical MM was much less strongly associated (aOR 4.32, 95% CI = 4.21 to 4.43). People in the most deprived decile had equivalent rates of multimorbidity at a younger age than those in the least deprived decile. This was most marked in mental-physical MM at 40-45 years younger, followed by MM2+ at 15-20 years younger, and MM3+ and MM3+ from 3+ at 10-15 years younger. Females had higher prevalence of multimorbidity under all definitions, which was most marked for mental-physical MM.Conclusion: Estimated prevalence of multimorbidity depends on the definition used, and associations with age, sex, and socioeconomic position vary between definitions. Applicable multimorbidity research requires consistency of definitions across studies.
KW - Female
KW - Humans
KW - Multimorbidity
KW - Cross-Sectional Studies
KW - Prevalence
KW - Socioeconomic Factors
KW - United Kingdom/epidemiology
KW - Primary Health Care
KW - epidemiology
KW - multimorbidity
KW - primary care
KW - socioeconomic disparities
UR - http://www.scopus.com/inward/record.url?scp=85151315843&partnerID=8YFLogxK
U2 - 10.3399/BJGP.2022.0405
DO - 10.3399/BJGP.2022.0405
M3 - Article
C2 - 36997222
SN - 0960-1643
VL - 73
SP - e249-e256
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 729
M1 - 10.3399/BJGP.2022.0405
ER -