Original articlePrevalence of Multimorbidity in a Geographically Defined American Population: Patterns by Age, Sex, and Race/Ethnicity
Section snippets
Study Population
Most medical care in Olmsted County, Minnesota, has been provided historically and is currently provided by a few health care institutions: Olmsted Medical Center and its affiliated hospital, Mayo Clinic and its two affiliated hospitals, Rochester Family Medicine Clinic, and a few smaller care facilities. The health care records from these institutions are linked together through the REP records linkage system.12, 13, 14 Persons are considered residents of Olmsted County at the time of each
Description of the Olmsted County Population
Overall, the REP infrastructure identified 142,992 Olmsted County residents on April 1, 2010, compared with 144,248 individuals counted by the US Census on the same day.23 Of 142,992 residents, 138,858 provided Minnesota research authorization for medical record research (97.1%) and were included in the analyses. Figure 1 and Supplemental Table 2 (available online at http://www.mayoclinicproceedings.org) show the age- and sex-specific prevalence of each of the 20 conditions considered
Principal Findings
In this study, multimorbidity was common, increased steeply with older age, and was similar in men and women overall. However, more men than women had 5 or more conditions. Despite the traditional focus on multimorbidity in the older adult population,5, 8, 9, 10, 11 the absolute number of persons affected by multimorbidity was higher in persons younger than 65 years than in those 65 years or older. Multimorbidity was also higher in blacks than in white persons and in white than in Asian
Conclusion
We described the prevalence of 20 chronic conditions across all age groups, in men and women separately, and across race/ethnic groups in the Olmsted County population. Multimorbidity is common in the general population; it increases steeply with age, has different patterns in men and women, and varies by race/ethnicity. These findings have implications for clinical practice and for etiologic research. On the one hand, the findings may inform the transition from single diagnosis-based
Acknowledgments
We thank Ms Carol J. Greenlee for her assistance in typing and formatting the manuscript.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
References (41)
- et al.
Aging with multimorbidity: a systematic review of the literature
Ageing Res Rev
(2011) - et al.
Multimorbidity patterns: a systematic review
J Clin Epidemiol
(2014) - et al.
Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study
Lancet
(2012) - et al.
History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population
Mayo Clin Proc
(2012) - et al.
Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project
Mayo Clin Proc
(2012) - et al.
Potential effect of authorization bias on medical record research
Mayo Clin Proc
(1999) - et al.
Risk of atrial fibrillation with use of oral and intravenous bisphosphonates
Am J Cardiol
(2014) Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability
Gen Hosp Psychiatry
(2007)Clinical and health services relationships between major depression, depressive symptoms, and general medical illness
Biol Psychiatry
(2003)Multimorbidity: redesigning health care for people who use it
Lancet
(2012)
Epidemiology of multimorbidity
Lancet
Epidemiology of multimorbidity: author's reply
Lancet
Coronary disease surveillance in Olmsted County objectives and methodology
J Clin Epidemiol
Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance
JAMA
Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidity
Age Ageing
Defining and measuring chronic conditions: imperatives for research, policy, program, and practice
Prev Chronic Dis
Multiple Chronic Conditions: A Strategic Framework: Optimum Health and Quality of Life for Individuals With Multiple Chronic Conditions
Multimorbidity in older adults
Epidemiol Rev
Managing multiple chronic conditions: a strategic framework for improving health outcomes and quality of life
Public Health Rep
The dimensions of multiple chronic conditions: where do we go from here? a commentary on the Special Issue of Preventing Chronic Disease
Prev Chronic Dis
Cited by (178)
Are we enrolling the right patients? A scoping review of external validity and generalizability of clinical trials in bloodstream infections
2023, Clinical Microbiology and InfectionDisparities in Clinical Ethics Consultation among Hospitalized Children: A Case-Control Study
2023, Journal of PediatricsSocioeconomic and Ethnic Inequalities in the Progress of Multimorbidity and the Role of Health Behaviors
2023, Journal of the American Medical Directors AssociationPotentially inappropriate medications increase while prevalence of polypharmacy/hyperpolypharmacy decreases in Japan: A comparison of nationwide prescribing data
2022, Archives of Gerontology and Geriatrics
For editorial comment, see page 1321
Grant Support: This study was made possible by the Rochester Epidemiology Project (grant number R01-AG034676; Principal Investigators: Walter A. Rocca, MD, MPH, and Barbara P. Yawn, MD, MSc). This study was also supported by the Paul Beeson Career Development Award Program (National Institute on Aging K23 AG032910), the John A. Hartford Foundation, Atlantic Philanthropies, the Starr Foundation, and an anonymous donor (all to C.M.B.).