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

Marjorie C Johnston; Corrinda Black; Stewart W Mercer; Gordon J Prescott; Michael A Crilly

doi:10.1136/bmjopen-2019-033622

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

Marjorie C Johnston^* (Corresponding Author), Corrinda Black, Stewart W Mercer, Gordon J Prescott, Michael A Crilly

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

13 Downloads (Pure)

Abstract

OBJECTIVES: Multimorbidity is the coexistence 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 of 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 of follow-up (to ages 60-66 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 9625 participants (51% males), 3% had multimorbidity. The death rate per 1000 person-years was 28.4 (95% CI 23.2 to 34.8) in those with multimorbidity and 5.7 (95% CI 5.3 to 6.1) in those without. In relation to the reference group of those with no multimorbidity, those with multimorbidity had a mortality HR of 4.5 (95% CI 3.4 to 6.0) over 15 years and this association remained when fully adjusted for the covariates (HR 2.5 (95% CI 1.5 to 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 language	English
Article number	e033622
Pages (from-to)	1-11
Number of pages	11
Journal	BMJ Open
Volume	10
Issue number	5
Early online date	5 May 2020
DOIs	https://doi.org/10.1136/bmjopen-2019-033622
Publication status	Published - 5 May 2020

Bibliographical note

Funding MCJ was funded by a Clinical Academic Fellowship from the Chief Scientist Office, Scotland (CAF/13/03), and was a PhD student affiliated with the Farr Institute of Health Informatics and Research Scotland.

Contributors Study conception: MCJ. Study design: MCJ, CB, SWM, GJP and MAC. Study analysis: MCJ. Supervision and contribution to study analysis: CB, SWM, GJP and MAC. Drafting of article: MCJ. Critical revision of the article for important intellectual content: MCJ, CB, SWM, GJP and MAC. Final approval of article: MCJ, CB, SWM, GJP and MAC

Keywords

cohort
multimorbidity
premature mortality

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/bmjopen-2019-033622Licence: CC BY-NC

Johnston_PrevalenceofSecondaryCareMultimorbidity_VOR
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Final published version, 517 KBLicence: CC BY-NC

Cite this

@article{140906ac0a28464c92a8ccc26308abdd,

title = "Prevalence of secondary care multimorbidity in mid-life and its association with premature mortality in a large longitudinal cohort study",

abstract = "OBJECTIVES: Multimorbidity is the coexistence 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 of 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 of follow-up (to ages 60-66 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 9625 participants (51% males), 3% had multimorbidity. The death rate per 1000 person-years was 28.4 (95% CI 23.2 to 34.8) in those with multimorbidity and 5.7 (95% CI 5.3 to 6.1) in those without. In relation to the reference group of those with no multimorbidity, those with multimorbidity had a mortality HR of 4.5 (95% CI 3.4 to 6.0) over 15 years and this association remained when fully adjusted for the covariates (HR 2.5 (95% CI 1.5 to 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.",

keywords = "cohort, multimorbidity, premature mortality",

author = "Johnston, {Marjorie C} and Corrinda Black and Mercer, {Stewart W} and Prescott, {Gordon J} and Crilly, {Michael A}",

note = "Funding MCJ was funded by a Clinical Academic Fellowship from the Chief Scientist Office, Scotland (CAF/13/03), and was a PhD student affiliated with the Farr Institute of Health Informatics and Research Scotland. Contributors Study conception: MCJ. Study design: MCJ, CB, SWM, GJP and MAC. Study analysis: MCJ. Supervision and contribution to study analysis: CB, SWM, GJP and MAC. Drafting of article: MCJ. Critical revision of the article for important intellectual content: MCJ, CB, SWM, GJP and MAC. Final approval of article: MCJ, CB, SWM, GJP and MAC ",

year = "2020",

month = may,

day = "5",

doi = "10.1136/bmjopen-2019-033622",

language = "English",

volume = "10",

pages = "1--11",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "5",

}

TY - JOUR

T1 - Prevalence of secondary care multimorbidity in mid-life and its association with premature mortality in a large longitudinal cohort study

AU - Johnston, Marjorie C

AU - Black, Corrinda

AU - Mercer, Stewart W

AU - Prescott, Gordon J

AU - Crilly, Michael A

N1 - Funding MCJ was funded by a Clinical Academic Fellowship from the Chief Scientist Office, Scotland (CAF/13/03), and was a PhD student affiliated with the Farr Institute of Health Informatics and Research Scotland. Contributors Study conception: MCJ. Study design: MCJ, CB, SWM, GJP and MAC. Study analysis: MCJ. Supervision and contribution to study analysis: CB, SWM, GJP and MAC. Drafting of article: MCJ. Critical revision of the article for important intellectual content: MCJ, CB, SWM, GJP and MAC. Final approval of article: MCJ, CB, SWM, GJP and MAC

PY - 2020/5/5

Y1 - 2020/5/5

N2 - OBJECTIVES: Multimorbidity is the coexistence 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 of 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 of follow-up (to ages 60-66 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 9625 participants (51% males), 3% had multimorbidity. The death rate per 1000 person-years was 28.4 (95% CI 23.2 to 34.8) in those with multimorbidity and 5.7 (95% CI 5.3 to 6.1) in those without. In relation to the reference group of those with no multimorbidity, those with multimorbidity had a mortality HR of 4.5 (95% CI 3.4 to 6.0) over 15 years and this association remained when fully adjusted for the covariates (HR 2.5 (95% CI 1.5 to 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.

AB - OBJECTIVES: Multimorbidity is the coexistence 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 of 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 of follow-up (to ages 60-66 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 9625 participants (51% males), 3% had multimorbidity. The death rate per 1000 person-years was 28.4 (95% CI 23.2 to 34.8) in those with multimorbidity and 5.7 (95% CI 5.3 to 6.1) in those without. In relation to the reference group of those with no multimorbidity, those with multimorbidity had a mortality HR of 4.5 (95% CI 3.4 to 6.0) over 15 years and this association remained when fully adjusted for the covariates (HR 2.5 (95% CI 1.5 to 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.

KW - cohort

KW - multimorbidity

KW - premature mortality

UR - http://www.scopus.com/inward/record.url?scp=85084328720&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2019-033622

DO - 10.1136/bmjopen-2019-033622

M3 - Article

C2 - 32371508

SN - 2044-6055

VL - 10

SP - 1

EP - 11

JO - BMJ Open

JF - BMJ Open

IS - 5

M1 - e033622

ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Aberdeen Maternity and Neonatal Databank

Children of the 1950's study: Aberdeen birth cohort

Cite this

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

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Datasets

Aberdeen Maternity and Neonatal Databank

Children of the 1950's study: Aberdeen birth cohort

Cite this