Objective The aim of this study is to describe the evolution of multimorbidity. Study Design and Setting Data from 1854 South Australians who participated in the North West Adelaide longitudinal Health Study(NWAHS) was collected between baseline (2000–2002) and follow-up (2008–2010). Status for eight chronic diseases (CDs) was determined by biomedical measurement or self-report. Chronic disease (CD) mean age of occurrence and order of appearance was investigated. Results The prevalence of multimorbidity increased from 32% to 64% during the 7.8±1.1 years of follow-up. The estimated mean age of onset of a new CD was significantly older for hypertension, cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) and younger for hypercholesterolemia, asthma and other mental problem. Hypercholesterolemia was more likely to develop as a first than as a subsequent CD (39%vs.16%, p<0.0001) while CVD (1%vs.5%, p<0.0001), diabetes (5%vs.11%, p<0.001) and COPD (6%vs.16%, p<0.0001) were less likely. The presence of mood disorders at baseline was associated with an increased risk of developing other mental disorders (36%vs.12%, p<0.0001), diabetes (18%vs.9%, p<0.01) and asthma (30%vs.21%, p<0.05). Conclusion Longitudinal data could be used to study the evolution of multimorbidity and could provide information on CDs mean age of occurrence, order of appearance and impact on the development of future CDs.
References
[1]
World Health Organisation (2011) Non communicable disease (NCD) profile.
[2]
Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L (2005) Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med 3: 223–228. doi: 10.1370/afm.272
[3]
Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H (2012) A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 10: 142–151. doi: 10.1370/afm.1337
[4]
Taylor AW, Price K, Gill TK, Adams R, Pilkington R, et al. (2010) Multimorbidity - not just an older person's issue. Results from an Australian biomedical study. BMC Public Health 10: 718. doi: 10.1186/1471-2458-10-718
[5]
Harrison C, Britt H, Miller G, Henderson J (2013) Prevalence of chronic conditions in Australia. PLoS One 8: e67494. doi: 10.1371/journal.pone.0067494
[6]
van den Akker M, Buntinx F, Knottnerus JA (1996) Comorbidity or multimorbidity what's in a name? A review of literature. European Journal of General Practice. pp. 65–70.
[7]
Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA (2011) Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. Br J Gen Pract 61: e12–21. doi: 10.3399/bjgp11x548929
[8]
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, et al. (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380: 37–43. doi: 10.1016/s0140-6736(12)60240-2
[9]
Broemeling AM, Watson DE, Prebtani F (2008) Population patterns of chronic health conditions, co-morbidity and healthcare use in Canada: implications for policy and practice. Healthc Q 11: 70–76. doi: 10.12927/hcq.2008.19859
[10]
Librero J, Peiro S, Ordinana R (1999) Chronic comorbidity and outcomes of hospital care: length of stay, mortality, and readmission at 30 and 365 days. J Clin Epidemiol 52: 171–179. doi: 10.1016/s0895-4356(98)00160-7
[11]
Fortin M, Bravo G, Hudon C, Lapointe L, Dubois MF, et al. (2006) Psychological distress and multimorbidity in primary care. Ann Fam Med 4: 417–422.
[12]
Diederichs CP, Wellmann J, Bartels DB, Ellert U, Hoffmann W, et al. (2012) How to weight chronic diseases in multimorbidity indices? Development of a new method on the basis of individual data from five population-based studies. J Clin Epidemiol 65: 679–685. doi: 10.1016/j.jclinepi.2011.11.006
[13]
France EF, Wyke S, Gunn JM, Mair FS, McLean G, et al. (2012) Multimorbidity in primary care: a systematic review of prospective cohort studies. Br J Gen Pract 62: e297–307. doi: 10.3399/bjgp12x636146
[14]
Marengoni A, von Strauss E, Rizzuto D, Winblad B, Fratiglioni L (2009) The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons. A community-based, longitudinal study. J Intern Med 265: 288–295. doi: 10.1111/j.1365-2796.2008.02017.x
[15]
Wong A, Boshuizen HC, Schellevis FG, Kommer GJ, Polder JJ (2011) Longitudinal administrative data can be used to examine multimorbidity, provided false discoveries are controlled for. J Clin Epidemiol 64: 1109–1117. doi: 10.1016/j.jclinepi.2010.12.011
[16]
Ruel G, Shi Z, Zhen S, Zuo H, Kroger E, et al. (2013) Association between nutrition and the evolution of multimorbidity: The importance of fruits and vegetables and whole grain products. Clin Nutr. In press. doi: 10.1016/j.clnu.2013.07.009
[17]
Schafer I (2012) Does multimorbidity influence the occurrence rates of chronic conditions? A claims data based comparison of expected and observed prevalence rates. PLoS One 7: e45390. doi: 10.1371/journal.pone.0045390
[18]
Grant JF, Chittleborough CR, Taylor AW, Dal Grande E, Wilson DH, et al. (2006) The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases. Epidemiol Perspect Innov 3: 4.
[19]
Grant JF, Taylor AW, Ruffin RE, Wilson DH, Phillips PJ, et al. (2009) Cohort Profile: The North West Adelaide Health Study (NWAHS). Int J Epidemiol 38: 1479–1486. doi: 10.1093/ije/dyn262
[20]
Taylor AW, Dal Grande E, Gill T, Chittleborough CR, Wilson DH, et al. (2006) Do people with risky behaviours participate in biomedical cohort studies? BMC Public Health 6: 11.
[21]
Taylor AW, Dal Grande E, Grant J, Appleton S, Gill TK, et al. (2013) Weighting of the data and analytical approaches may account for differences in overcoming the inadequate representativeness of the respondents to the third wave of a cohort study. J Clin Epidemiol 66: 461–464. doi: 10.1016/j.jclinepi.2012.06.021
[22]
Diagnosis and classification of diabetes mellitus. Diabetes Care 27 Suppl 1: S5–S10. doi: 10.2337/diacare.27.2007.s5
[23]
Chittleborough CR, Baldock KL, Taylor AW, Phillips PJ (2006) Health status assessed by the SF-36 along the diabetes continuum in an Australian population. Qual Life Res 15: 687–694. doi: 10.1007/s11136-005-3570-8
[24]
AIHW (2010) Australia's health 2010. In: AIHW, editor. Canberra: AIHW.
[25]
Appleton SL, Adams RJ, Wilson DH, Taylor AW, Ruffin RE (2005) Spirometric criteria for asthma: adding further evidence to the debate. J Allergy Clin Immunol 116: 976–982. doi: 10.1016/j.jaci.2005.08.034
[26]
Wilson D, Adams R, Appleton S, Ruffin R (2005) Difficulties identifying and targeting COPD and population-attributable risk of smoking for COPD: a population study. Chest 128: 2035–2042. doi: 10.1378/chest.128.4.2035
[27]
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, et al. (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62: 593–602. doi: 10.1001/archpsyc.62.6.593
[28]
Koopman RJ, Mainous AG 3rd, Diaz VA, Geesey ME (2005) Changes in age at diagnosis of type 2 diabetes mellitus in the United States, 1988 to 2000. Ann Fam Med 3: 60–63.
[29]
O'Donnell DE, Aaron S, Bourbeau J, Hernandez P, Marciniuk D, et al. (2003) Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease—2003. Can Respir J 10 Suppl A: 11A–65A.
[30]
Fuchs FD, Fuchs SC, Moreira LB, Gus M (2012) Proof of concept in cardiovascular risk: the paradoxical findings in blood pressure and lipid abnormalities. Vasc Health Risk Manag 8: 437–442. doi: 10.2147/vhrm.s32585
[31]
Vaidyanathan U, Patrick CJ, Iacono WG (2011) Patterns of comorbidity among mental disorders: a person-centered approach. Compr Psychiatry 52: 527–535. doi: 10.1016/j.comppsych.2010.10.006
[32]
Gadermann AM, Alonso J, Vilagut G, Zaslavsky AM, Kessler RC (2012) Comorbidity and disease burden in the National Comorbidity Survey Replication (NCS-R). Depress Anxiety 29: 797–806. doi: 10.1002/da.21924
[33]
Sinnige J, Braspenning J, Schellevis F, Stirbu-Wagner I, Westert G, et al. (2013) The prevalence of disease clusters in older adults with multiple chronic diseases - a systematic literature review. PLoS One 8: e79641. doi: 10.1371/journal.pone.0079641
[34]
Ceretta LB, Reus GZ, Abelaira HM, Jornada LK, Schwalm MT, et al. (2012) Increased prevalence of mood disorders and suicidal ideation in type 2 diabetic patients. Acta Diabetol. doi: 10.1007/s00592-012-0435-9
[35]
Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2002) Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res 53: 1053–1060. doi: 10.1016/s0022-3999(02)00417-8
[36]
Roy-Byrne PP, Davidson KW, Kessler RC, Asmundson GJ, Goodwin RD, et al. (2008) Anxiety disorders and comorbid medical illness. Gen Hosp Psychiatry 30: 208–225. doi: 10.1016/j.genhosppsych.2007.12.006
[37]
Jani BD, Purves D, Barry S, Cavanagh J, McLean G, et al. (2013) Challenges and implications of routine depression screening for depression in chronic disease and multimorbidity: a cross sectional study. PLoS One 8: e74610. doi: 10.1371/journal.pone.0074610
[38]
Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, et al. (2008) Examining a bidirectional association between depressive symptoms and diabetes. JAMA 299: 2751–2759. doi: 10.1001/jama.299.23.2751
[39]
Andersohn F, Schade R, Suissa S, Garbe E (2009) Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Am J Psychiatry 166: 591–598. doi: 10.1176/appi.ajp.2008.08071065
[40]
Chen Y, Patel NC (2010) Long term antidepressant use linked to increased risk of diabetes. Evid Based Ment Health 13: 30. doi: 10.1136/ebmh.13.1.30
[41]
Roberts RG, Gask L, Arndt B, Bower P, Dunbar J, et al. (2012) Depression and diabetes: the role and impact of models of health care systems. J Affect Disord 142 Suppl: S80–88 doi: 10.1016/s0165-0327(12)70012-5
[42]
Whalley B, Thompson DR, Taylor RS (2012) Psychological Interventions for Coronary Heart Disease: Cochrane Systematic Review and Meta-analysis. Int J Behav Med. doi: 10.1007/s12529-012-9282-x
[43]
Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM, et al. (2000) Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 23: 934–942. doi: 10.2337/diacare.23.7.934
[44]
Anderson RJ, Grigsby AB, Freedland KE, de Groot M, McGill JB, et al. (2002) Anxiety and poor glycemic control: a meta-analytic review of the literature. Int J Psychiatry Med 32: 235–247. doi: 10.2190/klgd-4h8d-4ryl-twq8
[45]
Adams RJ, Wilson DH, Taylor AW, Daly A, Tursan d'Espaignet E, et al. (2006) Coexistent chronic conditions and asthma quality of life: a population-based study. Chest 129: 285–291. doi: 10.1378/chest.129.2.285
[46]
Fessler MB, Massing MW, Spruell B, Jaramillo R, Draper DW, et al. (2009) Novel relationship of serum cholesterol with asthma and wheeze in the United States. J Allergy Clin Immunol 124: 967–974. doi: 10.1016/j.jaci.2009.08.005
[47]
Misso NL, Brooks-Wildhaber J, Ray S, Vally H, Thompson PJ (2005) Plasma concentrations of dietary and nondietary antioxidants are low in severe asthma. Eur Respir J 26: 257–264. doi: 10.1183/09031936.05.00006705
[48]
Kim TB, Oh YM, Chang YS, Cho YS, Jang AS, et al. (2012) The reality of an intermediate type between asthma and COPD in practice. Respir Care 57: 1248–1253. doi: 10.4187/respcare.01232
[49]
Hardin M, Silverman EK, Barr RG, Hansel NN, Schroeder JD, et al. (2011) The clinical features of the overlap between COPD and asthma. Respir Res 12: 127. doi: 10.1186/1465-9921-12-127
[50]
Gibson PG, Simpson JL (2009) The overlap syndrome of asthma and COPD: what are its features and how important is it? Thorax 64: 728–735. doi: 10.1136/thx.2008.108027
[51]
Chittleborough CR, Burke MJ, Taylor AW, Wilson DH, Phillips PJ, et al. (2009) Medicare-related service use and costs among people with diagnosed and undiagnosed diabetes and respiratory conditions. Aust Health Rev 33: 107–116. doi: 10.1071/ah090107
