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Multimorbidity, ageing and mortality: normative data and cohort study in an American population
OBJECTIVES: To describe the percentile distribution of multimorbidity across age by sex, race and ethnicity, and to demonstrate the utility of multimorbidity percentiles to predict mortality. DESIGN: Population-based descriptive study and cohort study. SETTING: Olmsted County, Minnesota (USA). PARTI...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986688/ https://www.ncbi.nlm.nih.gov/pubmed/33741663 http://dx.doi.org/10.1136/bmjopen-2020-042633 |
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author | Rocca, Walter A Grossardt, Brandon R Boyd, Cynthia M Chamberlain, Alanna M Bobo, William V St Sauver, Jennifer L |
author_facet | Rocca, Walter A Grossardt, Brandon R Boyd, Cynthia M Chamberlain, Alanna M Bobo, William V St Sauver, Jennifer L |
author_sort | Rocca, Walter A |
collection | PubMed |
description | OBJECTIVES: To describe the percentile distribution of multimorbidity across age by sex, race and ethnicity, and to demonstrate the utility of multimorbidity percentiles to predict mortality. DESIGN: Population-based descriptive study and cohort study. SETTING: Olmsted County, Minnesota (USA). PARTICIPANTS: We used the medical records-linkage system of the Rochester Epidemiology Project (REP; http://www.rochesterproject.org) to identify all residents of Olmsted County, Minnesota who reached one or more birthdays between 1 January 2005 and 31 December 2014 (10 years). METHODS: For each person, we obtained the count of chronic conditions (out of 20 conditions) present on each birthday by extracting all of the diagnostic codes received in the 5 years before the index birthday from the electronic indexes of the REP. To compare each person’s count to peers of same age, the counts were transformed into percentiles of the total population and displayed graphically across age by sex, race and ethnicity. In addition, quintiles 1, 2, 4 and 5 were compared with quintile 3 (reference) to predict the risk of death at 1 year, 5 years and through end of follow-up using time-to-event analyses. Follow-up was passive using the REP. RESULTS: We identified 238 010 persons who experienced a total of 1 458 094 birthdays during the study period (median of 6 birthdays per person; IQR 3–10). The percentiles of multimorbidity across age did not vary noticeably by sex, race or ethnicity. In general, there was an increased risk of mortality at 1 and 5 years for quintiles 4 and 5 of multimorbidity. The risk of mortality for quintile 5 was greater for younger age groups and for women. CONCLUSIONS: The assignment of multimorbidity percentiles to persons in a population may be a simple and intuitive tool to assess relative health status, and to predict short-term mortality, especially in younger persons and in women. |
format | Online Article Text |
id | pubmed-7986688 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-79866882021-03-29 Multimorbidity, ageing and mortality: normative data and cohort study in an American population Rocca, Walter A Grossardt, Brandon R Boyd, Cynthia M Chamberlain, Alanna M Bobo, William V St Sauver, Jennifer L BMJ Open Epidemiology OBJECTIVES: To describe the percentile distribution of multimorbidity across age by sex, race and ethnicity, and to demonstrate the utility of multimorbidity percentiles to predict mortality. DESIGN: Population-based descriptive study and cohort study. SETTING: Olmsted County, Minnesota (USA). PARTICIPANTS: We used the medical records-linkage system of the Rochester Epidemiology Project (REP; http://www.rochesterproject.org) to identify all residents of Olmsted County, Minnesota who reached one or more birthdays between 1 January 2005 and 31 December 2014 (10 years). METHODS: For each person, we obtained the count of chronic conditions (out of 20 conditions) present on each birthday by extracting all of the diagnostic codes received in the 5 years before the index birthday from the electronic indexes of the REP. To compare each person’s count to peers of same age, the counts were transformed into percentiles of the total population and displayed graphically across age by sex, race and ethnicity. In addition, quintiles 1, 2, 4 and 5 were compared with quintile 3 (reference) to predict the risk of death at 1 year, 5 years and through end of follow-up using time-to-event analyses. Follow-up was passive using the REP. RESULTS: We identified 238 010 persons who experienced a total of 1 458 094 birthdays during the study period (median of 6 birthdays per person; IQR 3–10). The percentiles of multimorbidity across age did not vary noticeably by sex, race or ethnicity. In general, there was an increased risk of mortality at 1 and 5 years for quintiles 4 and 5 of multimorbidity. The risk of mortality for quintile 5 was greater for younger age groups and for women. CONCLUSIONS: The assignment of multimorbidity percentiles to persons in a population may be a simple and intuitive tool to assess relative health status, and to predict short-term mortality, especially in younger persons and in women. BMJ Publishing Group 2021-03-19 /pmc/articles/PMC7986688/ /pubmed/33741663 http://dx.doi.org/10.1136/bmjopen-2020-042633 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/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/. |
spellingShingle | Epidemiology Rocca, Walter A Grossardt, Brandon R Boyd, Cynthia M Chamberlain, Alanna M Bobo, William V St Sauver, Jennifer L Multimorbidity, ageing and mortality: normative data and cohort study in an American population |
title | Multimorbidity, ageing and mortality: normative data and cohort study in an American population |
title_full | Multimorbidity, ageing and mortality: normative data and cohort study in an American population |
title_fullStr | Multimorbidity, ageing and mortality: normative data and cohort study in an American population |
title_full_unstemmed | Multimorbidity, ageing and mortality: normative data and cohort study in an American population |
title_short | Multimorbidity, ageing and mortality: normative data and cohort study in an American population |
title_sort | multimorbidity, ageing and mortality: normative data and cohort study in an american population |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986688/ https://www.ncbi.nlm.nih.gov/pubmed/33741663 http://dx.doi.org/10.1136/bmjopen-2020-042633 |
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