Age, sex, and socioeconomic differences in multimorbidity measured in four ways: UK primary care cross-sectional analysis

Clare MacRae, Stewart W Mercer, David Henderson, Megan McMinn, Daniel R Morales, Emily Jefferson, Ronan Lyons, Jane Lyons, Chris Dibben, David A McAllister, Bruce Guthrie

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Multimorbidity poses major challenges to healthcare systems worldwide. Definitions with cut-offs of more than ≥2 long-term conditions (LTCs) might better capture populations with complexity but are not standardised.

Aim: This study examined variation in prevalence using different definitions of multimorbidity.

Design and setting: Cross-sectional study of 1168620 people in England.

Methods: Comparison of multimorbidity prevalence using four definitions: MM2+ (≥2 LTCs), MM3+ (≥3 LTCs), MM3+ from 3+ (≥3 LTCs from ≥3 ICD-10 chapters), and mental-physical MM (≥2 LTCs where ≥1 mental and ≥1 physical). Logistic regression was used to examine patient characteristics associated with multimorbidity under all four definitions.

Results: MM2+ was most common (40.4%) followed by MM3+ (27.5%), MM3+ from 3+ (22.6%), and mental-physical MM (18.9%). MM2+, MM3+, and MM3+ from 3+ were strongly associated with oldest age (aOR 58.09 [56.13-60.14]), aOR 77.69 [75.33-80.12]), and aOR 102.06 [98.61-105.65] respectively), but mental-physical MM was much less strongly associated (aOR 4.32 [4.21-4.43]). People in the most deprived decile had equivalent rates of multimorbidity at a younger age than those in the least deprived. This was most marked in mental-physical MM at 40-45 years younger, followed by MM2+ at 15-20 years, and MM3+ and MM3+ from 3+ at 10-15 years. Women had higher prevalence of multimorbidity under all definitions, which was most marked for mental-physical MM.

Conclusion: Estimated prevalence of multimorbidity depends on the definition used, and associations with age, sex, and socioeconomic position vary between definitions. Applicable multimorbidity research requires consistency of definitions across studies.
Original languageEnglish
JournalBritish Journal of General Practice
Early online date7 Oct 2022
Publication statusE-pub ahead of print - 7 Oct 2022


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