The epidemiology of multimorbidity in France: Variations by gender, age and socioeconomic factors, and implications for surveillance and prevention

Coste, Joël; Valderas, José M; Carcaillon‐Bentata, Laure

doi:10.1371/journal.pone.0265842

Cited by 8 publications

(5 citation statements)

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“…Multimorbidity prevalence is rising in the US, leading to concerns that its impact on health-related quality of life, health care utilization and costs, and mortality, which is already substantial, may be amplified . In population studies across varied high-income settings, female sex has emerged as a risk factor for multimorbidity development and progression . In these studies, multimorbidity was associated with obesity, mental health disorders, substance use, and lower SES, variables often differing by sex and gender and exacerbated in women with HIV .…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22] In population studies across varied high-income settings, female sex has emerged as a risk factor for multimorbidity development and progression. 21,[23][24][25] In these studies, multimorbidity was associated with obesity, mental health disorders, substance use, and lower SES, [23][24][25] variables often differing by sex and gender 26 and exacerbated in women with HIV. 27 In this study of the WIHS/MACS cohorts, we found that NACM burden was significantly higher in women vs men overall (3.4 vs 3.2) and among PWH specifically, but not among HIV-seronegative peers.…”

Section: Jama Network Open | Infectious Diseasesmentioning

confidence: 95%

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Aging-Related Comorbidity Burden Among Women and Men With or At-Risk for HIV in the US, 2008-2019

et al. 2023

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ImportanceDespite aging-related comorbidities representing a growing threat to quality-of-life and mortality among persons with HIV (PWH), clinical guidance for comorbidity screening and prevention is lacking. Understanding comorbidity distribution and severity by sex and gender is essential to informing guidelines for promoting healthy aging in adults with HIV.ObjectiveTo assess the association of human immunodeficiency virus on the burden of aging-related comorbidities among US adults in the modern treatment era.Design, Setting, and ParticipantsThis cross-sectional analysis included data from US multisite observational cohort studies of women (Women’s Interagency HIV Study) and men (Multicenter AIDS Cohort Study) with HIV and sociodemographically comparable HIV-seronegative individuals. Participants were prospectively followed from 2008 for men and 2009 for women (when more than 80% of participants with HIV reported antiretroviral therapy use) through last observation up until March 2019, at which point outcomes were assessed. Data were analyzed from July 2020 to April 2021.ExposuresHIV, age, sex.Main Outcomes and MeasuresComorbidity burden (the number of total comorbidities out of 10 assessed) per participant; secondary outcomes included individual comorbidity prevalence. Linear regression assessed the association of HIV status, age, and sex with comorbidity burden.ResultsA total of 5929 individuals were included (median [IQR] age, 54 [46-61] years; 3238 women [55%]; 2787 Black [47%], 1153 Hispanic or other [19%], 1989 White [34%]). Overall, unadjusted mean comorbidity burden was higher among women vs men (3.4 [2.1] vs 3.2 [1.8]; P = .02). Comorbidity prevalence differed by sex for hypertension (2188 of 3238 women [68%] vs 2026 of 2691 men [75%]), psychiatric illness (1771 women [55%] vs 1565 men [58%]), dyslipidemia (1312 women [41%] vs 1728 men [64%]), liver (1093 women [34%] vs 1032 men [38%]), bone disease (1364 women [42%] vs 512 men [19%]), lung disease (1245 women [38%] vs 259 men [10%]), diabetes (763 women [24%] vs 470 men [17%]), cardiovascular (493 women [15%] vs 407 men [15%]), kidney (444 women [14%] vs 404 men [15%]) disease, and cancer (219 women [7%] vs 321 men [12%]). In an unadjusted model, the estimated mean difference in comorbidity burden among women vs men was significantly greater in every age strata among PWH: age under 40 years, 0.33 (95% CI, 0.03-0.63); ages 40 to 49 years, 0.37 (95% CI, 0.12-0.61); ages 50 to 59 years, 0.38 (95% CI, 0.20-0.56); ages 60 to 69 years, 0.66 (95% CI, 0.42-0.90); ages 70 years and older, 0.62 (95% CI, 0.07-1.17). However, the difference between sexes varied by age strata among persons without HIV: age under 40 years, 0.52 (95% CI, 0.13 to 0.92); ages 40 to 49 years, −0.07 (95% CI, −0.45 to 0.31); ages 50 to 59 years, 0.88 (95% CI, 0.62 to 1.14); ages 60 to 69 years, 1.39 (95% CI, 1.06 to 1.72); ages 70 years and older, 0.33 (95% CI, −0.53 to 1.19) (P for interaction = .001). In the covariate-adjusted model, findings were slightly attenuated but retained statistical significance.Conclusions and RelevanceIn this cross-sectional study, the overall burden of aging-related comorbidities was higher in women vs men, particularly among PWH, and the distribution of comorbidity prevalence differed by sex. Comorbidity screening and prevention strategies tailored by HIV serostatus and sex or gender may be needed.

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Section: Discussionmentioning

confidence: 99%

Section: Jama Network Open | Infectious Diseasesmentioning

confidence: 95%

Aging-Related Comorbidity Burden Among Women and Men With or At-Risk for HIV in the US, 2008-2019

et al. 2023

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“…Wetzel et al, indicates that informing about health care usage, giving information to choose a care provider, and facilitate contact the service provider (providing patient information, preparing for active participation) improved the elderly participation because people had acquired much information about it [ 47 ]. Other studies revealed that access to PHC was higher in people with chronic disease showing that healthcare providers prioritize them with higher needs [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

A framework for elderly participation in Primary Health Care in Tabriz Health complexes

Najafi,

Gholipour,

Amerzadeh

et al. 2023

BMC Geriatr

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Background A framework for increasing elderly participation in Primary Health Care (PHC) is a vital issue considering the growing population. After examining the situation and elderly participation in the provision of PHC in the health complexes of Tabriz City, the present study presents the framework of elderly participation in PHC. Methods This is a mixed-method study. First, we reviewed the models of elderly participation in PHC worldwide using a comprehensive search of literature. Then, we extracted the service providers’ and the elderly's views regarding the obstacles and solutions for the elderly participation in PHC in Iran using the interviews and focus group discussions (FGD). We conducted three FGDs (8–10 people) and seven individual interviews. Data were analyzed using the content analysis method. We developed the proposed framework for the participation of the elderly in PHC using a panel of experts and checked and confirmed the framework's validity using the Delphi technique with 11 experts from the content validity index and modified kappa coefficient. Results Based on the result of included studies in the systematic review, the characteristics of the participation models were classified into five areas: the characteristics of the service user, the main facilitator of the intervention, the type of ownership of the center, the subject and the method of participation. The solutions and obstacles, and problems presented by the service providers and users in different areas include 12 themes (elderly participation, home care, and self-care, respect for the elderly, cooperation of different organizations, service package for the elderly, referral system, planning for the elderly, considering insurance for the elderly, the role of informing the elderly, mental health of the elderly, physical space of centers and training of elderly caregivers) and 46 sub-themes. The final framework also includes five themes (approaches and strategies to attract participation, indicators, and consequences of participation of the elderly, implementation strategies of elderly care, implementation infrastructure and goals and areas of participation of the elderly) and sub-themes. Conclusion The results of the study indicate that the final framework obtained should be used based on a systematic model for elderly participation in PHC and should be implemented and followed up based on local strategies and specific indicators, considering all capacities.

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“…Along with the adverse temporal trends of cardiovascular diseases and stroke in young adults in France and the importance of cardiometabolic disorders in the burden of multimorbidity (mainly functional limitations and mortality) at a young age, the high levels observed for the seven cardiovascular risk factors described in this study further highlight the urgent need for ambitious prevention programmes. 2 , 3 , 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

Need for improvement of cardiovascular health: a clustering method to identify cardiovascular health profiles.

Soyer

Gabet

Grave

et al. 2023

European Journal of Public Health

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Background In France, the overall trend in the incidence of cardiovascular disease is unfavourable, especially in young subjects. This highlights the need to promote cardiovascular health by targeting the main risk factors. Social marketing campaigns to improve cardiovascular health should identify unhealthy behaviour and understand the target audience. The objective of this study was to identify poor cardiovascular health profiles in the French population using a clustering method. Methods Subjects aged 18–74 years with no history of cardiovascular disease were included from the Esteban cross-sectional survey (2014–16). To evaluate cardiovascular health, seven items were considered as defined by the American Heart Association: blood glucose, blood cholesterol, blood pressure, body mass index, cigarette smoking, diet and physical activity. Cardiovascular health profiles were identified from these seven items by combining multiple correspondence analysis with hierarchical clustering and partitioning. Results A total of 1673 subjects were included in the main analysis. Five cardiovascular health profiles were identified: two profiles corresponded to subjects with poor cardiovascular health (mainly older men with a low socioeconomic status), two to subjects with intermediate cardiovascular health (one mainly comprised of young women with a low socioeconomic status and the other of young subjects with a high socioeconomic status) and one to subjects with good cardiovascular health (mainly older women). Conclusion This description of cardiovascular health profiles, which led to the identification and characterization of target audiences for future population-based prevention campaigns, should be the starting point for improving cardiovascular health in the French population.

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The epidemiology of multimorbidity in France: Variations by gender, age and socioeconomic factors, and implications for surveillance and prevention

Cited by 8 publications

References 60 publications

Aging-Related Comorbidity Burden Among Women and Men With or At-Risk for HIV in the US, 2008-2019

Aging-Related Comorbidity Burden Among Women and Men With or At-Risk for HIV in the US, 2008-2019

A framework for elderly participation in Primary Health Care in Tabriz Health complexes

Need for improvement of cardiovascular health: a clustering method to identify cardiovascular health profiles.

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