Shang, X and Peng, W and Hill, E and Szoeke, C and He, M and Zhang, L, Incidence, progression, and patterns of multimorbidity in community- dwelling middle-aged men and women, Frontiers in Public Health, 8 Article 404. ISSN 2296-2565 (2020) [Refereed Article]
Copyright 2020 Shang, Peng, Hill, Szoeke, He and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Methods: We included 53,867 participants aged 45–64 years from the 45 and Up Study who were free of 10 predefined chronic conditions at baseline (2006–2009). The incidence of multimorbidity (coexistence of 2, 3, and 4 conditions) was identified using the claims database until December 31, 2016. The primary, secondary, tertiary, and quaternary condition for each participant was defined according to its temporal order of onset.
Results: During a mean 9-years follow-up, the cumulative incidence of primary, secondary, tertiary, and quaternary conditions was 49.6, 23.7, 9.0, and 2.9%, respectively. The time to develop a subsequent condition decreased with the accumulation of conditions (P < 0.0001). Two concurrent cardiometabolic disorders (CMDs, 30.4%) and CMDs clustered with musculoskeletal disorders (15.2%), mental disorders (13.5%), asthma (12.0%), or cancer (8.7%) were the five most common multimorbidity patterns. CMDs tended to occur prior to mental or musculoskeletal disorders but after the onset of cancers or asthma. Compared with all participants who developed cancer as a primary condition, individuals who experienced mental disorders/neurodegenerative disorders and a comorbidity as cardiovascular disease, hypertension, dyslipidemia, diabetes, asthma, or osteoarthritis were 3.36–10.87 times more likely to develop cancer as a tertiary condition. Individuals with neurodegenerative disorders and a comorbidity as hypertension, dyslipidemia, osteoarthritis, or asthma were 5.14–14.15 times more likely to develop mental disorders as a tertiary condition.
Conclusions: A high incidence of multimorbidity in middle-aged adults was observed and CMDs were most commonly seen in multimorbidity patterns. There may be accelerated aging after a primary condition occurs. Our findings also reveal a potential preventative window to obviate the development of secondary or tertiary conditions.
|Item Type:||Refereed Article|
|Keywords:||multimorbidity, epidemiology, patterns, disease, patterns of multimorbidity, time to develop subsequent conditions, primary condition, secondary condition, tertiary condition, quaternary condition|
|Research Division:||Health Sciences|
|Research Field:||Epidemiological methods|
|Objective Group:||Specific population health (excl. Indigenous health)|
|Objective Field:||Health related to ageing|
|UTAS Author:||Hill, E (Dr Edward Hill)|
|Web of Science® Times Cited:||2|
|Deposited By:||Wicking Dementia Research and Education Centre|
|Downloads:||3 View Download Statistics|
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