Abstract
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.
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 language | English |
---|---|
Journal | British Journal of General Practice |
Early online date | 7 Oct 2022 |
DOIs | |
Publication status | E-pub ahead of print - 7 Oct 2022 |