The prevalence of secondary care multimorbidity in mid-life and its association with premature mortality in a large longitudinal cohort study

MC Johnston, C Black, Stewart Mercer, GJ Prescott, M Crilly

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives
Multimorbidity is the co-existence of two or more health conditions in an individual. Multimorbidity in younger adults is increasingly recognised as an important challenge. We assessed the prevalence of secondary care multimorbidity in mid-life and its association with premature mortality over 15 years follow-up, in the Aberdeen Children of the 1950s (ACONF) cohort.
Method
A prospective cohort study using linked electronic health and mortality records. Scottish ACONF participants were linked to their Scottish Morbidity Record hospital episode data and mortality records. Multimorbidity was defined as two or more conditions and was assessed using healthcare records in 2001 when the participants were aged between 45 and 51 years. The association between multimorbidity and mortality over 15 years follow-up (to ages 60 to 66 years) was assessed using Cox proportional hazards regression. There was also adjustment for key covariates: age, gender, social class at birth, intelligence at age 7, secondary school type, educational attainment, alcohol, smoking, body mass index and adult social class.
Results
Of 9,625 participants (51% male), 3% had multimorbidity. The death rate per 1,000 person years was 28.4 (95% CI 23.2-34.8) in those with multimorbidity and 5.7 (95% CI 5.3-6.1) in those without. In relation to the reference group of those with no multimorbidity, those with multimorbidity had a mortality hazard ratio (HR) of 4.5 (95% CI 3.4-6.0) over 15 years and this association remained when fully adjusted for the covariates (HR 2.5 [95% CI 1.5-4.0]).
Conclusion
Multimorbidity prevalence was 3% in mid-life when measured using secondary care administrative data. Multimorbidity in mid-life was associated with premature mortality.
Original languageEnglish
JournalBMJ Open
DOIs
Publication statusPublished - 5 May 2020

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