Multimorbidity in a cohort of middle-aged women: Risk factors and disease clustering

Abstract

We aimed to evaluate which risk factors in middle-aged women are associated with higher risk of multimorbidity in older age. Study design: We conducted a prospective cohort study from 1990 to 1993 in Santiago de Chile, Chile among women aged 40-59 (at baseline). Diagnosed illnesses were retrieved from national health records in 2020. Main outcome measures: : Clinical and laboratory evaluation was conducted. Results: 1066 women were followed-up for a mean of 27.8 years, after which 49.7% presented multimorbidity. These women, as compared with those without multimorbidity, were more likely at baseline to have had obesity (20.4% vs. 8.6%, p < 0.001); be post-menopause (47.2% vs. 40.5%; p < 0.03); have jobs that did not require a qualification (74.2% vs. 56.0%, p < 0.001); arterial hypertension (19.8% vs 14.4%, p < 0.018); lower HDLcholesterol (51.3 ± 12.9 vs. 53.6 ± 12.7 mg/dL, p < 0.005); and higher triglyceride levels (136.0 ± 65.0 vs. 127.0 ± 74.0 mg/dL, p = 0.028). Hypertension was associated in 22.0% of women with diabetes, in 20.9% with osteoarthritis and 14.0% with depression. Osteoarthritis was also associated with diabetes mellitus (8.3%) and depression (7.8%). Diabetes mellitus, in addition to hypertension and osteoarthritis, was associated with depression (6.4%). In a logistic regression model, we observed that obesity in middle-aged women was the strongest risk factor for multimorbidity in the elderly (OR: 2.48; 95% CI, 1.71-3.61), followed by having a job that did not require a qualification (OR: 2.18; 95% CI, 1.67-2.83) and having a low HDL-cholesterol level (OR: 1.31; 95% CI, 1.02-1.68). Conclusions: Multimorbidity was highly prevalent in this older female population. Obesity in middle-aged women was the strongest risk factor for multimorbidity at older age. These results are relevant for Chile and other countries with similar population profiles.

Prevalence and patterns of multimorbidity in chronic diseases in Guangzhou, China: a data mining study in the residents’ health records system among 31 708 community-dwelling elderly people

“…Similar result was reported in a prospective cohort study, prevalent of multimorbidity of diabetes–hypertension was 12.5% 32. Blümel et al found that hypertension coexisted in 22.0% of women with diabetes 33. Prathapan et al found that a fourth of the sample was affected by multimorbidity of diabetes and hypertension, and the combinations of coronary heart disease with hypertension and diabetes were also significantly prevalent 34.…”

Scientific Research in Ecuador: A Bibliometric Analysis

“…In Latin America, there are mainly epidemiological problems [191][192][193][194]. Physical inactivity in Ecuador is the highest reported worldwide and ranks fifth as a risk factor for mortality [195,196], obesity [197,198] and COVID-19 [199][200][201].…”

Pattern and Predicting Risk Factors of Multi-Morbidity in the AzarCohort Population Using Structural Equation Model

“…It should be noted that our findings are in line with previous studies that reported hypertension, diabetes, dyslipidemia, and obesity as the most common CDs in population 23 . Also, the most prevalent CDs reported in the population studied in Blümela et al were hypertension, arthrosis, diabetes, and depression 12 . In this regard, Read et al reported that the risk of depression was doubled in patients with MM, compared with subjects without MM 24 .…”

“…However, these complex demands increase the workload of health-care centers and create unnecessary expenses for the system and patients. Thus, managing the prevalence of MM in patients is among the most crucial challenges in modern medicine and is a global research priority 12 .…”