The influence of age, gender and socio-economic status on multimorbidity patterns in primary care : first results from the MultiCare Cohort study

  • Background: Multimorbidity is a phenomenon with high burden and high prevalence in the elderly. Our previous research has shown that multimorbidity can be divided into the multimorbidity patterns of 1) anxiety, depression, somatoform disorders (ADS) and pain, and 2) cardiovascular and metabolic disorders. However, it is not yet known, how these patterns are influenced by patient characteristics. The objective of this paper is to analyze the association of socio-demographic variables, and especially socio-economic status with multimorbidity in general and with each multimorbidity pattern. Methods: The MultiCare Cohort Study is a multicentre, prospective, observational cohort study of 3.189 multimorbid patients aged 65+ randomly selected from 158 GP practices. Data were collected in GP interviews and comprehensive patient interviews. Missing values have been imputed by hot deck imputation based on Gower distance in morbidity and other variables. The association of patient characteristics with the number of chronic conditions is analysed by multilevel mixed-effects linear regression analyses. Results: Multimorbidity in general is associated with age (+0.07 chronic conditions per year), gender (-0.27 conditions for female), education (-0.26 conditions for medium and -0.29 conditions for high level vs. low level) and income (-0.27 conditions per logarithmic unit). The pattern of cardiovascular and metabolic disorders shows comparable associations with a higher coefficient for gender (-1.29 conditions for female), while multimorbidity within the pattern of ADS and pain correlates with gender (+0.79 conditions for female), but not with age or socioeconomic status. Conclusions: Our study confirms that the morbidity load of multimorbid patients is associated with age, gender and the socioeconomic status of the patients, but there were no effects of living arrangements and marital status. We could also show that the influence of patient characteristics is dependent on the multimorbidity pattern concerned, i.e. there seem to be at least two types of elderly multimorbid patients. First, there are patients with mainly cardiovascular and metabolic disorders, who are more often male, have an older age and a lower socio-economic status. Second, there are patients mainly with ADS and pain-related morbidity, who are more often female and equally distributed across age and socio-economic groups.

Download full text files

  • Full text PDF

  • Additional file 1: Table S1. Multimorbidity patterns by gender* - results from tetrachoric factor analyses.

  • Additional file 2: Table S2. Intercentre differences in socio-demographic data of patients at baseline (n = 3,189).

  • Additional file 3: Table S3. Comparison of study participants and non-responders regarding the chance for study participation: results from multilevel logistic regression analysis allowing for random effects at the study centre and GP practice-within-study centre level.

Export metadata

Metadaten
Author:Ingmar SchäferGND, Heike Hansen, Gerhard SchönORCiDGND, Susanne Höfels, Attila Altiner, Anne Maren DahlhausGND, Jochen GensichenORCiDGND, Steffi Gerlinde Riedel-HellerORCiDGND, Siegfried WeyererORCiDGND, Wolfgang A. Blank, Hans-Helmut König, Olaf von dem Knesebeck, Karl Wegscheider, Martin SchererGND, Hendrik van den BusscheORCiDGND, Birgitt WieseORCiDGND
URN:urn:nbn:de:hebis:30:3-228001
DOI:https://doi.org/doi:10.1186/1472-6963-12-89
ISSN:1472-6963
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/22471952
Parent Title (English):BMC health services research
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Language:English
Date of Publication (online):2012/05/22
Date of first Publication:2012/04/03
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2012/05/22
Volume:12
Issue:Art. 89
Page Number:15
First Page:1
Last Page:15
Note:
Copyright: © Schäfer et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
HeBIS-PPN:30289621X
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 2.0