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J Public Health (Oxf). 2019 Mar 1;41(1):80-89. doi: 10.1093/pubmed/fdy017.

Multimorbidity in South Asian adults: prevalence, risk factors and mortality.

Author information

1
Public Health Foundation of India, Gurgaon, Haryana, India.
2
Centre for Control of Chronic Conditions, Gurgaon, Haryana, India.
3
Amity Institute of Applied Science (AIAS), Amity University, Noida, India.
4
Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
5
Centre for Chronic Disease Control, Gurgaon, Haryana, India.
6
Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
7
Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan.
8
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, NCR, India.

Abstract

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.

KEYWORDS:

South Asia; chronic disease; mortality; multimorbidity

PMID:
29425313
DOI:
10.1093/pubmed/fdy017

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