Abstract
BackgroundMultimorbidity, the simultaneous occurrence of two or more chronic conditions, is usually associated with older persons. This research assessed multimorbidity across a range of ages so that planners are informed and appropriate prevention programs, management strategies and health service/health care planning can be implemented.MethodsMultimorbidity was assessed across three age groups from data collected in a major biomedical cohort study (North West Adelaide Health Study). Using randomly selected adults, diabetes, asthma, and chronic obstructive pulmonary disease were determined clinically and cardio-vascular disease, osteoporosis, arthritis and mental health by self-report (ever been told by a doctor). A range of demographic, social, risk and protective factors including high blood pressure and high cholesterol (assessed bio-medically), health service use, quality of life and medication use (linked to government records) were included in the multivariate modelling.ResultsOverall 4.4% of the 20-39 year age group, 15.0% of the 40-59 age group and 39.2% of those aged 60 years of age or older had multimorbidity (17.1% of the total). Of those with multimorbidity, 42.1% were aged less than 60 years of age. A variety of variables were included in the final logistic regression models for the three age groups including family structure, marital status, education attainment, country of birth, smoking status, obesity measurements, medication use, health service utilisation and overall health status.ConclusionsMultimorbidity is not just associated with older persons and flexible care management support systems, appropriate guidelines and care-coordination programs are required across a broader age range. Issues such as health literacy and polypharamacy are also important considerations. Future research is required into assessing multimorbidity across the life course, prevention of complications and assessment of appropriate self-care strategies.
Highlights
Multimorbidity, the simultaneous occurrence of two or more chronic conditions, is usually associated with older persons
These prevalence estimates vary depending on the method of data collection [1], definition of chronic conditions [16], definition of multimorbidity [12,14,16,17,18] and the number of chronic conditions included in the analysis [2,15,16]
57.9% are in the older age group with 42.1% aged less than 60 years of age
Summary
Multimorbidity, the simultaneous occurrence of two or more chronic conditions, is usually associated with older persons. The simultaneous occurrence of two or more chronic conditions [1,2] are at increased risk of less than best practice care [3,4] They tend to have more frequent and longer hospitalisations [1,5], greater use of polypharmacy (causing adverse drug effects) [3,6], spend more on their health [4,7,8] and use a greater range of other health care services [3,4]. Notwithstanding, due to the ageing population and increased longevity, the prevalence of multimorbidity is expected to increase It is imperative in the current climate of limited health resources, to move beyond focusing on single chronic conditions and older persons only, to a focus on multimorbidity across all age groups [1,16]. There are important implications for public health and health services/health care planning, especially in regard to the call for increased emphasis on primary care and self management
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