TY - JOUR
T1 - Multimorbidity in South Asian adults
T2 - Prevalence, risk factors and mortality
AU - Singh, Kalpana
AU - Patel, Shivani A.
AU - Biswas, Suddhendu
AU - Shivashankar, Roopa
AU - Kondal, Dimple
AU - Ajay, Vamadevan S.
AU - Anjana, Ranjit Mohan
AU - Fatmi, Zafar
AU - Ali, Mohammed K.
AU - Kadir, M. Masood
AU - Mohan, Viswanathan
AU - Tandon, Nikhil
AU - Narayan, K. M.Venkat
AU - Prabhakaran, Dorairaj
N1 - Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background We report the prevalence, risk factors and mortality associated with multimorbidity in urban South Asian adults. Methods Hypertension, diabetes, heart disease, stroke and chronic kidney disease were measured at baseline in a sample of 16 287 adults ages ≥20 years in Delhi, Chennai and Karachi in 2010-11 followed for an average of 38 months. Multimorbidity was defined as having ≥2 chronic conditions at baseline. We identified correlates of multimorbidity at baseline using multinomial logistic models, and we assessed the prospective association between multimorbidity and mortality using Cox proportional hazards models. Results The adjusted prevalence of multimorbidity was 9.4%; multimorbidity was highest in adults who were aged ≥60 years (37%), consumed alcohol (12.3%), body mass index ≥25 m/kg2 (14.1%), high waist circumference (17.1%) and had family history of a chronic condition (12.4%). Compared with adults with no chronic conditions, the fully adjusted relative hazard of death was twice as high in adults with two morbidities (hazard ratio [HR] = 2.3; 95% confidence interval [CI]: 1.6, 3.3) and thrice as high in adults with ≥3 morbidities (HR = 3.1; 95% CI: 1.9, 5.1). Conclusion Multimorbidity affects nearly 1 in 10 urban South Asians, and each additional morbidity carries a progressively higher risk of death. Identifying locally appropriate strategies for prevention and coordinated management of multimorbidity will benefit population health in the region.
AB - Background We report the prevalence, risk factors and mortality associated with multimorbidity in urban South Asian adults. Methods Hypertension, diabetes, heart disease, stroke and chronic kidney disease were measured at baseline in a sample of 16 287 adults ages ≥20 years in Delhi, Chennai and Karachi in 2010-11 followed for an average of 38 months. Multimorbidity was defined as having ≥2 chronic conditions at baseline. We identified correlates of multimorbidity at baseline using multinomial logistic models, and we assessed the prospective association between multimorbidity and mortality using Cox proportional hazards models. Results The adjusted prevalence of multimorbidity was 9.4%; multimorbidity was highest in adults who were aged ≥60 years (37%), consumed alcohol (12.3%), body mass index ≥25 m/kg2 (14.1%), high waist circumference (17.1%) and had family history of a chronic condition (12.4%). Compared with adults with no chronic conditions, the fully adjusted relative hazard of death was twice as high in adults with two morbidities (hazard ratio [HR] = 2.3; 95% confidence interval [CI]: 1.6, 3.3) and thrice as high in adults with ≥3 morbidities (HR = 3.1; 95% CI: 1.9, 5.1). Conclusion Multimorbidity affects nearly 1 in 10 urban South Asians, and each additional morbidity carries a progressively higher risk of death. Identifying locally appropriate strategies for prevention and coordinated management of multimorbidity will benefit population health in the region.
KW - Chronic disease
KW - Mortality
KW - Multimorbidity
KW - South Asia
UR - http://www.scopus.com/inward/record.url?scp=85062953186&partnerID=8YFLogxK
U2 - 10.1093/pubmed/fdy017
DO - 10.1093/pubmed/fdy017
M3 - Article
C2 - 29425313
AN - SCOPUS:85062953186
SN - 1741-3842
VL - 41
SP - 80
EP - 89
JO - Journal of Public Health
JF - Journal of Public Health
IS - 1
ER -