Abstract
BackgroundMultimorbidity occurs at a younger age in individuals in areas of high socioeconomic deprivation but little is known about the ‘typology’ of multimorbidity in different age groups and its association with socioeconomic status.AimTo characterise multimorbidity type and most common conditions in a large nationally representative primary care dataset in terms of age and deprivation.Design and settingCross-sectional analysis of 1 272 685 adults in Scotland.MethodMultimorbidity type of participants (physical-only, mental-only, mixed physical, and mental) and most common conditions were analysed according to age and deprivation.ResultsMultimorbidity increased with age, ranging from 8.1% in those aged 25–34 to 76.1% for those aged ≥75 years. Physical-only (56% of all multimorbidity) was the most common type of multimorbidity in those aged ≥55 years, and did not vary substantially with deprivation. Mental-only was uncommon (4% of all multimorbidity), whereas mixed physical and mental (40% of all multimorbidity) was the most common type of multimorbidity in those aged <55 years and was two- to threefold more common in the most deprived compared with the least deprived in most age groups. Ten conditions (seven physical and three mental) accounted for the top five most common conditions in people with multimorbidity in all age groups. Depression and pain featured in the top five conditions across all age groups. Deprivation was associated with a higher prevalence of depression, drugs misuse, anxiety, dyspepsia, pain, coronary heart disease, and diabetes in multimorbid patients at different ages.ConclusionMixed physical and mental multimorbidity is common across the life-span and is exacerbated by deprivation from early adulthood onwards.
Highlights
Mixed physical and mental multimorbidity is common across the life-span and is exacerbated by deprivation from early adulthood onwards
Multimorbidity is associated with poor health outcomes, including higher mortality[5,6] and lower quality of life,[7] resulting in more complex healthcare needs[8] and higher healthcare costs.[9,10]
The dataset was obtained from the Primary Care Clinical Informatics Unit at the University of Aberdeen, UK, and included copies of clinical data for 1 751 841 patients of all ages, permanently registered with 314 Scottish general practices, who were alive on 31 March 2007.15 The dataset consisted of complete copies of clinical data for all registered patients caring for about one-third of the Scottish population
Summary
Multimorbidity, defined here as the coexistence of two or more chronic conditions in the same individual, presents a challenge to patients, clinicians, healthcare systems, and researchers.[1,2,3,4] Multimorbidity is associated with poor health outcomes, including higher mortality[5,6] and lower quality of life,[7] resulting in more complex healthcare needs[8] and higher healthcare costs.[9,10] Estimates of the prevalence of multimorbidity vary depending on the study population, the definition of multimorbidity used, and the use of different numbers and definitions of conditions.[11,12] Regardless of how it is measured, multimorbidity is more common in older people,[13,14] and in more deprived populations.[15]To date, research on multimorbidity has mainly focused on older people.[16,17,18,19] several studies have shown that multimorbidity is not just a problem of old age.[15,20,21] a recent large study found more people with multimorbidity aged
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