000135782 001__ 135782
000135782 005__ 20240614091948.0
000135782 0247_ $$2doi$$a10.3389/fpubh.2024.1349723
000135782 0248_ $$2sideral$$a138806
000135782 037__ $$aART-2024-138806
000135782 041__ $$aeng
000135782 100__ $$aIoakeim-Skoufa, Ignatios
000135782 245__ $$aMultimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study
000135782 260__ $$c2024
000135782 5060_ $$aAccess copy available to the general public$$fUnrestricted
000135782 5203_ $$aIntroduction: The presence of multiple chronic conditions, also referred to as multimorbidity, is a common finding in adults. Epidemiologic research can help identify groups of individuals with similar clinical profiles who could benefit from similar interventions. Many cross-sectional studies have revealed the existence of different multimorbidity patterns. Most of these studies were focused on the older population. However, multimorbidity patterns begin to form at a young age and can evolve over time following distinct multimorbidity trajectories with different impact on health. In this study, we aimed to identify multimorbidity patterns and trajectories in adults 18–65 years old.
Methods: We conducted a retrospective longitudinal epidemiologic study in the EpiChron Cohort, which includes all inhabitants of Aragón (Spain) registered as users of the Spanish National Health System, linking, at the patient level, information from electronic health records from both primary and specialised care. We included all 293,923 patients 18–65 years old with multimorbidity in 2011. We used cluster analysis at baseline (2011) and in 2015 and 2019 to identify multimorbidity patterns at four and eight years of follow-up, and we then created alluvial plots to visualise multimorbidity trajectories. We performed age- and sex-adjusted logistic regression analysis to study the association of each pattern with four- and eight-year mortality.
Results: We identified three multimorbidity patterns at baseline, named dyslipidaemia & endocrine-metabolic, hypertension & obesity, and unspecific. The hypertension & obesity pattern, found in one out of every four patients was associated with a higher likelihood of four- and eight-year mortality (age- and sex-adjusted odds ratio 1.11 and 1.16, respectively) compared to the unspecific pattern. Baseline patterns evolved into different patterns during the follow-up.
Discussion: Well-known preventable cardiovascular risk factors were key elements in most patterns, highlighting the role of hypertension and obesity as risk factors for higher mortality. Two out of every three patients had a cardiovascular profile with chronic conditions like diabetes and obesity that are linked to low-grade systemic chronic inflammation. More studies are encouraged to better characterise the relatively large portion of the population with an unspecific disease pattern and to help design and implement effective and comprehensive strategies towards healthier ageing.
000135782 536__ $$9info:eu-repo/grantAgreement/ES/DGA-FEDER/B01-23R$$9info:eu-repo/grantAgreement/ES/ISCIII-RICAPPS/RD21-0016-0019
000135782 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000135782 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000135782 700__ $$0(orcid)0000-0003-2580-2002$$aGonzález-Rubio, Francisca
000135782 700__ $$aAza-Pascual-Salcedo, Mercedes
000135782 700__ $$aLaguna-Berna, Clara
000135782 700__ $$0(orcid)0000-0002-5119-5093$$aPoblador-Plou, Beatriz
000135782 700__ $$aVicente-Romero, Jorge
000135782 700__ $$aCoelho, Helena
000135782 700__ $$aSantos-Mejías, Alejandro
000135782 700__ $$0(orcid)0000-0002-5704-6056$$aPrados-Torres, Alexandra
000135782 700__ $$aMoreno-Juste, Aida
000135782 700__ $$0(orcid)0000-0002-5440-1710$$aGimeno-Miguel, Antonio
000135782 773__ $$g12 (2024), [14 pp.]$$pFront. public health.$$tFrontiers in public health$$x2296-2565
000135782 8564_ $$s994750$$uhttps://zaguan.unizar.es/record/135782/files/texto_completo.pdf$$yVersión publicada
000135782 8564_ $$s2407287$$uhttps://zaguan.unizar.es/record/135782/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000135782 909CO $$ooai:zaguan.unizar.es:135782$$particulos$$pdriver
000135782 951__ $$a2024-06-14-09:00:18
000135782 980__ $$aARTICLE