Prevalence Of Common Chronic Diseases Research Articles

Prevalence of common chronic disease and multimorbidity patterns in Guangdong province with three typical cultures: analysis of data from the Diverse Life-Course Cohort study.

Variations in the prevalence and pattern of multimorbidity might be attributable to lifestyle and environmental factors. This study was performed to determine the prevalence of common chronic diseases and to reveal multimorbidity patterns among adults in Guangdong province with Chaoshan, Hakka, and island cultures. We used data collected at the baseline survey (April-May 2021) of the Diverse Life-Course Cohort study and included 5,655 participants aged ≥20 years. Multimorbidity was defined as the presence of two or more of the 14 chronic diseases collected by self-reports, physical examinations, and blood tests. Multimorbidity patterns were explored by association rule mining (ARM). Overall, 40.69% of participants had multimorbidity, and the prevalence among coastland (42.37%) and mountain residents (40.36%) was higher than that among island residents (37.97%). The prevalence of multimorbidity increased rapidly with higher age groups and showed an inflection point at 50 years, beyond which >50% of the middle-aged and older adults had multimorbidity. The proportion of people with two chronic diseases accounted for most cases of multimorbidity, and the strongest association was found between hyperuricemia and gout (lift of 3.26). The most prevalent multimorbidity pattern was dyslipidemia and hyperuricemia in the coastland areas and dyslipidemia combined with hypertension in the mountain and island areas. Furthermore, the most common triad combination consisted of cardiovascular diseases, gout, and hyperuricemia, which was verified in the mountain and coastal areas. These observations of multimorbidity patterns, including the most frequent multimorbidity and associations, will help healthcare providers develop healthcare plans that improve the effectiveness of multimorbidity management.

EPH77 Prevalence of Common Chronic Diseases Among Overweight and Obese Adults in Greece

EPH77 Prevalence of Common Chronic Diseases Among Overweight and Obese Adults in Greece

Health status and risk profiles for brain aging of rural-dwelling older adults: Data from the interdisciplinary baseline assessments in MIND-China.

IntroductionMultidomain intervention approaches have emerged as a potential strategy to reduce dementia risk. We sought to describe the baseline assessment approaches, health conditions, and risk profiles for brain aging of participants in the randomized controlled Multimodal INterventions to delay Dementia and disability in rural China (MIND‐China).MethodsMIND‐China engaged residents who were ≥60 years of age and living in rural communities in the western Shandong province. In March to September 2018, all participants underwent the core module assessments via face‐to‐face interviews, clinical examinations, neuropsychological testings, and laboratory tests. Specific modules of examination were performed for sub‐samples, including brain magnetic resonance imaging scans, genetic and blood biochemical markers, actigraphy testing, cardiopulmonary coupling analysis for sleep quality and disturbances, audiometric testing, and optical coherence tomography examination. We performed descriptive analysis.ResultsIn total, 5765 participants (74.9% of all eligible residents) undertook the baseline assessments. The mean age was 70.9 years (standard deviation, 5.9), 57.2% were women, 40.6% were illiterate, and 88.3% were farmers. The overall prevalence of common chronic diseases was 67.2% for hypertension, 23.4% for dyslipidemia, 23.5% for heart disease, 14.4% for diabetes mellitus, and 5.4% for dementia. The prevalence rates of hypertension, diabetes mellitus, dyslipidemia, obesity, heart disease, depressive symptoms, and dementia were higher in women than in men (P < .05). Overall, 87.1% of the participants had at least two of the 15 chronic diseases (89.3% in women vs 84.2% in men, P < .001). Participants examined for the specific modules were younger, more likely to be women, and more educated than those not examined.DiscussionComprehensive baseline assessments of participants in MIND‐China provide extremely valuable data sources for interdisciplinary research into the complex relationships of aging, health, brain aging, and functional consequences among older adults living in the rural communities.Highlights MIND‐China is a multimodal intervention study among rural residents ≥60 years of age.At baseline, 5765 participants undertook the interdisciplinary assessments.The baseline assessments consisted of core module and specific modules.Specific modules included brain magnetic resonance imaging (MRI), blood biomarkers, ActiGraph, cardiopulmonary coupling (CPC), pure‐tone audiometry (PTA), and optical coherence tomography (OCT).

Using Large Aggregated De-Identified Electronic Health Record Data to Determine the Prevalence of Common Chronic Diseases in Pediatric Patients Who Visited Primary Care Clinics.

We used de-identified clinical data from multiple health care systems using different electronic health records (EHRs) to 1) quantify the prevalence of common pediatric chronic diseases, 2) investigate patent characteristics associated with common pediatric chronic diseases, and 3) compare the results of our methodology to determine chronic disease prevalence with traditional approaches. We used a HIPAA-compliant and de-identified web application (Explorys; IBM Watson Health Explorys Inc.) to identify patients 17 years old or younger from multiple health care systems in the US who were seen in primary care clinics between 2016-2018 to determine the most common chronic conditions in this age group. The prevalence of chronic conditions was compared between different age groups, genders, races/ethnicities, and insurance; odds ratios and confidence intervals were calculated and reported. The top 6 chronic conditions identified by prevalence were: obesity/overweight (36.7%), eczema (15.8%), asthma (12.7%), food allergies (4.7%), attention deficit-hyperactivity disorder (4.09%) and hypertension (4.07%). Chronic conditions were generally more prevalent among relatively older pediatric patients, males, and African-American and multiracial groups. Approximately 40% of children and adolescents have at least one chronic disease. Obesity/overweight, eczema, and asthma are the most common chronic diseases of childhood, in the US, among those seeking care in health care systems with EHRs. The work compiled herein demonstrates that aggregated, standardized, normalized and de-identified population-level EHR data can provide both sufficient insight and statistical power to calculate the prevalence of chronic diseases and the odds ratio of various risk factors.

Prevalence and Patterns of Comorbidity Among Middle-Aged and Elderly People in China: A Cross-Sectional Study Based on CHARLS Data.

IntroductionUnder the background of the accelerated aging of the population, comorbidity in the elderly has gradually become a social problem. At present, the related studies on chronic diseases are mainly focused on a single disease. This study aimed to investigate the prevalence of common chronic diseases, the conditions and patterns of comorbidity in middle-aged and elderly people in China.MethodsWe extracted the data from China Health and Retirement Longitudinal Study (CHARLS). A total of 14 diseases were included, and the prevalence was assessed by self-report. We calculate different disease combinations and perform descriptive statistics analysis of chronic disease and comorbidity status.ResultsAmong the 6754 subjects, 2833 (42.0%) people had at least one chronic disease, and 1138 (17.0%) people had two or more diseases at the same time. The top three diseases of prevalence were hypertension (15.4%), arthritis or rheumatism (11.0%), and stomach or digestive diseases (9.3%). Common dual disease combinations were hypertension and dyslipidemia, hypertension and arthritis or rheumatism, arthritis or rheumatism and stomach or digestive diseases.ConclusionComorbidity is common in the population, and the pattern of chronic disease comorbidity is complex. Hypertension exists in a variety of comorbidity patterns, and its screening and prevention should be strengthened.

Progress in research of association of adverse childhood experiences with prevalence of common chronic diseases in adulthood

The effects of adverse childhood experiences on adult health has aroused increasing concern in the world in recent years, but limited studies have been conducted in China. This study synthesized the measurement of adverse childhood experiences, the association between adverse childhood experiences and the prevalence common chronic diseases in adulthood and possible mechanisms. It was found that though measurement range of adverse childhood experiences might be different among studies, current used measurement scales basically met the requirement of disease prevention. Most categories of adverse childhood experiences were positively related to risk of common chronic diseases, and the relationship was influenced by social economic status, sex and age. However, people with exposure to famine in childhood had lower prevalence of hypertension compared with those without the exposure. The possible mechanisms might be that the occurrence of adverse childhood experiences might damage physiological functions or increase the adoption of poor healthy behaviors and lifestyles, and finally increased the risk of chronic diseases directly or indirectly. While premature death due to adverse childhood experiences might reverse the association because of nonrandom selection. It is necessary for us to select appropriate indexes of adverse childhood experiences and conduct more studies to prove the association between adverse childhood experiences and prevalence of common chronic diseases in adulthood and explore the related mechanism for the better prevention of chronic diseases in China.

47. PREDICTING AND UNDERSTANDING CONTINUITY IN A RESIDENT CONTINUITY CLINIC

Background The longitudinal experience in continuity clinic plays a crucial role in building a strong foundation in general pediatrics. Pediatric residents struggle to maintain continuity in their clinics, which may impact comfort in managing common chronic pediatric conditions. Little is known about the prevalence of common chronic diseases managed on resident panels and if they are associated with resident continuity. Objectives We hypothesize that the presence of common chronic disease will be associated with resident continuity. We will also determine prevalence of common chronic diseases seen in clinic. This study will help inform a prospective quality improvement (QI) project. Methods Unique patients that had been seen for at least two non-urgent care visits (with at least one well visit) in our residency continuity clinic over a 2-year period were identified. To date, 618 of 685 patient charts reviewed meet the visit criteria. We have defined continuity as seeing the same resident provider for two or more visits. We have defined a resident primary care provider (PCP) as a resident who has seen a patient for >50% of their visits. Patient visit data and presence of chronic diseases for each patient were recorded in a password-protected Excel database. Results Of the 685 patients reviewed, there were 5584 unique visits, of which 3775 visits were related to well care (68%). Of those that met inclusion criteria (618), 309 (50%) met our definition for continuity, and 116 (16.9%) met our definition for having an identified resident PCP. For patients that had an identified resident PCP, they were less likely than those without one to have chronic diseases such as ADHD (0.86% vs. 3.56%, OR 0.28), obesity (6% vs. 15.5%, OR 0.78) and anxiety/depression (1.7% vs. 5.5%, OR 0.53). Conclusions While data collection/analysis is incomplete, it is clear that achieving continuity in a resident clinic is challenging. Chronic diseases are unlikely to be associated with resident continuity. QI interventions may be needed to increase resident continuity particularly among patients with common chronic pediatric conditions

Epidemic of chronic diseases and the related healthy lifestyle interventions in rural areas of Shandong Province, China

BackgroundThere were amounts of previous studies on chronic diseases, but few studies on the prevalence of chronic disease and the healthy lifestyle intervention in recent years, China. This study aimed to investigate the prevalence of chronic disease and the implementation of healthy lifestyle intervention in rural areas of China, so as to put forward health promotion measures to control the chronic diseases effectively.MethodA large cross-sectional study (N = 2168) on community diagnosis and chronic disease was carried out in Shandong province, China. The chronic disease questionnaire and the healthy lifestyle intervention questionnaires were recruited to survey the chronic diseases and the implementation of healthy lifestyle intervention. Physical examination and biochemical indicators examination were carried out by the medical staffs and clinical laboratory.ResultsThe current diagnosed prevalence of hypertension, diabetes, hyperlipidemia for total sample, female, male were 24.97, 24.6, 25.5, 7.60, 8.9, 6.0 and 40.27%, 45.9, 33.3% respectively in rural China. The one-year prevalence of myocardial infarction (MI) and stroke of the total sample, female, male were 1.06, 1.0, 1.1 and 2.09%, 2.2, 2.0% respectively.Healthy lifestyles interventions were not effective in rural China. The current active smoking rate and passive smoking rate were 25.68 and 42.65%. 27.86% of the population drunk alcohol within a month and 47.01% of them participated in the actions to control salt daily intake. Only 1.07 and 7.89% of the population participated in medium to high intensity physical exercises.ConclusionsThe prevalence of common chronic diseases were still high and the implementation of healthy lifestyle intervention were not optimal in rural area, China. Challenges to prevent chronic diseases were still severe, so medical institutes, government and individuals would put forward effective strategies to reduce the prevalence and public health promotion project should be effectively strengthened.

Complexity in disease management: A linked data analysis of multimorbidity in Aboriginal and non-Aboriginal patients hospitalised with atherothrombotic disease in Western Australia.

BackgroundHospitalisation for atherothrombotic disease (ATD) is expected to rise in coming decades. However, increasingly, associated comorbidities impose challenges in managing patients and deciding appropriate secondary prevention. We investigated the prevalence and pattern of multimorbidity (presence of two or more chronic conditions) in Aboriginal and non-Aboriginal Western Australian residents with ATDs.Methods and findingsWe used population-based de-identified linked administrative health data from 1 January 2000 to 30 June 2014 to identify a cohort of patients aged 25–59 years admitted to Western Australian hospitals with a discharge diagnosis of ATD. The prevalence of common chronic diseases in these patients was estimated and the patterns of comorbidities and multimorbidities empirically explored using two different approaches: identification of the most commonly occurring pairs and triplets of comorbid diseases, and through latent class analysis (LCA). Half of the cohort had multimorbidity, although this was much higher in Aboriginal people (Aboriginal: 79.2% vs. non-Aboriginal: 39.3%). Only a quarter were without any documented comorbidities. Hypertension, diabetes, alcohol abuse disorders and acid peptic diseases were the leading comorbidities in the major comorbid combinations across both Aboriginal and non-Aboriginal cohorts. The LCA identified four and six distinct clinically meaningful classes of multimorbidity for Aboriginal and non-Aboriginal patients, respectively. Out of the six groups in non-Aboriginal patients, four were similar to the groups identified in Aboriginal patients. The largest proportion of patients (33% in Aboriginal and 66% in non-Aboriginal) was assigned to the “minimally diseased” (or relatively healthy) group, with most patients having less than two conditions. Other groups showed variability in degree and pattern of multimorbidity.ConclusionMultimorbidity is common in ATD patients and the comorbidities tend to interact and cluster together. Physicians need to consider these in their clinical practice. Different treatment and secondary prevention strategies are likely to be useful for management in these cluster groups.

Pharmaceutical cost and multimorbidity with type 2 diabetes mellitus using electronic health record data.

BackgroundThe objective of the study is to estimate the frequency of multimorbidity in type 2 diabetes patients classified by health statuses in a European region and to determine the impact on pharmaceutical expenditure.MethodsCross-sectional study of the inhabitants of a southeastern European region with a population of 5,150,054, using data extracted from Electronic Health Records for 2012. 491,854 diabetic individuals were identified and selected through clinical codes, Clinical Risk Groups and diabetes treatment and/or blood glucose reagent strips. Patients with type 1 diabetes and gestational diabetes were excluded. All measurements were obtained at individual level. The prevalence of common chronic diseases and co-occurrence of diseases was established using factorial analysis.ResultsThe estimated prevalence of diabetes was 9.6 %, with nearly 70 % of diabetic patients suffering from more than two comorbidities. The most frequent of these was hypertension, which for the groups of patients in Clinical Risk Groups (CRG) 6 and 7 was 84.3 % and 97.1 % respectively. Regarding age, elderly patients have more probability of suffering complications than younger people. Moreover, women suffer complications more frequently than men, except for retinopathy, which is more common in males. The highest use of insulins, oral antidiabetics (OAD) and combinations was found in diabetic patients who also suffered cardiovascular disease and neoplasms. The average cost for insulin was 153€ and that of OADs 306€. Regarding total pharmaceutical cost, the greatest consumers were patients with comorbidities of respiratory illness and neoplasms, with respective average costs of 2,034.2€ and 1,886.9€.ConclusionsDiabetes is characterized by the co-occurrence of other diseases, which has implications for disease management and leads to a considerable increase in consumption of medicines for this pathology and, as such, pharmaceutical expenditure.

Relationship between gait speed and the health-related status in Chinese elderly

Objective To investigate the association between gait speed (GS) and the health-related status in the elderly, in order to provide a basis for the early detection of the decline in health status, cognitive and physical functions in the elderly. Methods A cross-sectional study was conducted. The questionnaire was designed to collect information on demographics, history of diseases, and lifestyles, etc. GS was measured by 10-meter and return walk test (totally 20 meters), and the speed less than 0.7 m/s was used to define low GS. Results Low GS was associated with the health status of the elderly. The prevalence of common chronic diseases was increased by 10% in the elderly with low GS than in the elderly with control GS after adjusting for age and gender (P<0.05). Stepwise Logistic regression showed that irregular daily routine (OR=1.39, P<0.01), co-morbidity (OR=2.00, P<0.01), low performance of instrumental activities of daily living (IADL) (OR=1.15, P<0.01), depression status (OR=1.02, P=0.001) were associated with low GS. While higher education level (OR=0.95, P=0.044), regular drinking (OR=0.78, P=0.002), better cognitive function (OR=0.95, P<0.01) were associated with faster GS. Conclusions Gait speed is significantly associated with health status, cognitive function, activities of daily living and psychologic status in the elderly. Gait speed measurement may help identify the early declines in health status, cognitive and physical functions. Key words: Walking; Cognition; Activities of daily living; Depression

Chronic diseases among the elderly in a rural Vietnam: prevalence, associated socio-demographic factors and healthcare expenditures

BackgroundGlobally, the population of elderly persons is increasing as well as the prevalence of chronic diseases. This change is causing increased healthcare costs to health care systems threatening to push many households into poverty. Low and middle income countries are projected to experience the greatest impact from this change. This study aims to describe the prevalence of common chronic diseases (CCDs) among the elderly in Vietnam, the associated socio-demographic factors and healthcare expenditures.MethodsThis is a cross-sectional study in the FilaBavi demographic surveillance site in Vietnam. 2873 persons over 60 years were randomly sampled. Prevalence of CCDs was reported from study subjects who previously were informed by physicians. Healthcare expenditures were determined from recall of expenses during the last hospital visit. Binomial logistic regression was done to determine the socio demographic predictors of having a CCD or multiple CCDs. Mean healthcare expenditures for the elderly with CCDs and those without CCDs were summarised and compared.ResultsForty two percent of the elderly were found to have at least one CCD. Joint problems were the most common CCD at 35 %, followed by hypertension at 15 % and chronic bronchitis at 11 %. Being female (OR = 1.51, 95 % CI = 1.03–2.21, p-value = 0.036), higher education (OR = 2.54, 95 % CI = 1.13–5.74, p-value = 0.025) and having advanced age (OR = 1.92, 95 % CI = 1.22–3.00, p-value = 0.005), were associated with common chronic diseases in the elderly. Outpatient healthcare expenditures were found to be significantly higher for the elderly with CCDs than those without CCDs.ConclusionsHigher education and being female are important key predictors of having a CCD, while wealth quintile is a predictor of multimorbidity, in the elderly. Healthcare expenditures for outpatient health services are higher for elderly persons with CCDs and these costs should be targeted when planning for financial protection.

Multimorbidity and Comorbidity of Chronic Diseases among the Senior Australians: Prevalence and Patterns

Understanding patterns and identifying common clusters of chronic diseases may help policymakers, researchers, and clinicians to understand the needs of the care process better and potentially save both provider and patient time and cost. However, only limited research has been conducted in this area, and ambiguity remains as those limited previous studies used different approaches to identify common clusters and findings may vary with approaches. This study estimates the prevalence of common chronic diseases and examines co-occurrence of diseases using four approaches: (i) identification of the most occurring pairs and triplets of comorbid diseases; performing (ii) cluster analysis of diseases, (iii) principal component analysis, and (iv) latent class analysis. Data were collected using a questionnaire mailed to a cross-sectional sample of senior Australians, with 4574 responses. Eighty-two percent of respondents reported having at least one chronic disease and over 52% reported having at least two chronic diseases. Respondents suffering from any chronic diseases had an average of 2.4 comorbid diseases. Three defined groups of chronic diseases were identified: (i) asthma, bronchitis, arthritis, osteoporosis and depression; (ii) high blood pressure and diabetes; and (iii) cancer, with heart disease and stroke either making a separate group or “attaching” themselves to different groups in different analyses. The groups were largely consistent across the approaches. Stability and sensitivity analyses also supported the consistency of the groups. The consistency of the findings suggests there is co-occurrence of diseases beyond chance, and patterns of co-occurrence are important for clinicians, patients, policymakers and researchers. Further studies are needed to provide a strong evidence base to identify comorbid groups which would benefit from appropriate guidelines for the care and management of patients with particular disease clusters.

Factors explaining excess stroke prevalence in the US Stroke Belt.

Higher risk and burden of stroke have been observed within the southeastern states (the Stroke Belt) compared with elsewhere in the United States. We examined reasons for these disparities using a large data set from a nationwide cross-sectional study. Self-reported data from the 2005 and 2007 Behavioral Risk Factor Surveillance System were used (n=765,368). The potential contributors for self-reported stroke prevalence (n=27 962) were demographics (age, sex, geography, and race/ethnicity), socioeconomic status (education and income), common risk factors (smoking and obesity), and chronic diseases (hypertension, diabetes, and coronary heart disease). Multivariate logistic regression was used in the analysis. The age- and sex-adjusted OR comparing self-reported stroke prevalence in the 11-state Stroke Belt versus non-Stroke Belt region was 1.25 (95% CI, 1.19 to 1.31). Unequal black/white distribution by region accounted for 20% of the excess prevalence in the Stroke Belt (OR reduced to 1.20; 1.15 to 1.26). Approximately one third (32%) of the excess prevalence was accounted either by socioeconomic status alone or by risk factors and chronic disease alone (OR, 1.12). The OR was further reduced to 1.07 (1.02 to 1.13) in the fully adjusted logistic model, a 72% reduction. Differences in socioeconomic status, risk factors, and prevalence of common chronic diseases account for most of the regional differences in stroke prevalence.

Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries

Few studies have compared socioeconomic inequalities in the prevalence of both fatal and non-fatal diseases. This paper aims to give the first international overview for several common chronic diseases. Micro-level data were pooled from non-standardized national health surveys conducted in eight European countries in the 1990s. Surveys ranged in size from 3700 to 41 200 participants. The prevalence of 17 chronic disease groups were analysed in relation to education. Standardized prevalence rates and age-adjusted odds ratios (ORs) were calculated. Most diseases showed higher prevalence among the lower education group. Stroke, diseases of the nervous system, diabetes, and arthritis displayed relatively large inequalities (OR > 1.50). No socioeconomic differences were evident for cancer, kidney diseases, and skin diseases. Allergy was more common in the higher education group. Relative socioeconomic differences were often smaller among the 60-79 age group as compared with the 25-59 age group. Cancer was more prevalent among the lower educated in the 25-59 age group, but among the higher educated in the 60-79 age group. For diabetes, hypertension, and heart disease, socioeconomic differences were larger among women as compared with men. Inequalities in heart disease were larger in northern European countries as compared with southern European countries. There are large variations between chronic diseases in the size and pattern of socioeconomic differences in their prevalence. The large inequalities that are found for some specific fatal diseases (e.g. stroke) and non-fatal diseases (e.g. arthritis) require special attention in equity-oriented research and policies.

Self-reported Health, Illness, and Self-care Among Finnish Physicians: A National Survey

Physicians' health problems have been discussed mainly in relation to substance abuse and psychiatric disorders. In this study, the prevalence of common chronic diseases and their treatment were determined. To find differences in self-reported health status, amount of sick leave, and the use of health services among physicians according to sex and specialty. Data were also compared with those of the total employed population. Cross-sectional postal questionnaire survey in Finland. A random sample of licensed physicians younger than 66 years (n = 4477) was randomly selected from the register of the Finnish Medical Association. A total of 3313 physicians (74%) responded. Perceived health, prevalence of diseases, self-treatment of diseases, amount of sick leave, and medical consultations. Female physicians assessed their health as being better than other female employees and had used health services and had been on sick leave more often than their male colleagues. Male physicians assessed their health as being equal to that of other men. Both female and male physicians had fewer sick leave than other employees. However, physicians-especially men-reported many common chronic illnesses as often or more often than other employees. Physicians had consulted other medical professionals less often than other employees, and they primarily self-treated their illnesses. Of the specialties, psychiatrists had used health services and had been on sick leave more often than other physicians. This study indicates that the usual form of care of physicians' diseases is self-treatment and "working through" illnesses. Arch Fam Med. 2000;9:1079-1085