Multimorbidity in adults from a southern Brazilian city: occurrence and patterns
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The aim of this study was to evaluate occurrences and patterns of multimorbidity in adults from a southern Brazilian city.
A population-based cross-sectional study was carried out in 2012 through face-to-face interviews with adults (20 or more years) living in Pelotas, southern Brazil. Multimorbidity was evaluated by a list of 11 morbidities (based on medical diagnosis; Patient Health Questionnaire 9 for depression; and Anatomical Therapeutic Chemical index) and operationalized according to two cutoff points: ≥2 and ≥3 morbidities. Descriptive analysis and factor analysis (FA) were performed.
The sample was made up of 2927 adults. Multimorbidity reached 29.1 % (95 % CI: 27.1; 31.1) for ≥2, and 14.3 % (95 % CI: 12.8; 15.8) for ≥3 morbidities and was greater in females, older people, those with less schooling and those from lower economic classes. Four pairs (frequency ≥5 %) and four triplets (frequency ≥2 %) were observed. Two patterns of morbidities (cardiometabolic and joint problems; and respiratory diseases) explained 93 % of total variance.
Multimorbidity was common in the studied population. The observed patterns may be used to generate and improve Brazilian diseases guidelines.
KeywordsComorbidity Multimorbidity Chronic diseases Statistical disease clustering Elderly Brazil
- Associação Brasileira de Empresas de Pesquisa (2010) Critério de Classificação Econômica Brasil. Associação Brasileira de Empresas de Pesquisa, São PauloGoogle Scholar
- CSDH (2008) Closing the gap in a generation: health equity through action on the social determinants of health. final report of the commission on social determinants of health. World Health Organization, GenevaGoogle Scholar
- Kubinger K (2003) On artificial results due to using factor analysis for dichotomous variables. Psycol Sci 45:106–110Google Scholar
- Le Reste JY et al (2013) The European general practice research network presents a comprehensive definition of multimorbidity in family medicine and long term care, following a systematic review of relevant literature. J Am Med Dir Assoc 14(5):319–325. doi: 10.1016/j.jamda.2013.01.001 CrossRefPubMedGoogle Scholar
- Moraes EN (2012) Health care for the elderly: conceptual aspects. Pan American Health Organization, Brasília, p 98Google Scholar
- Norman G, Streiner D (2008) Principal components and factor analysis. Fooling around with factors biostatistics: the bare essentials, 3rd edn. Bc Decker, HamiltonGoogle Scholar
- Vellakkal S et al (2014) Are estimates of socioeconomic inequalities in chronic disease artefactually narrowed by self-reported measures of prevalence in low-income and middle-income countries? Findings from the WHO-SAGE survey. J Epidemiol Community Health. doi: 10.1136/jech-2014-204621 PubMedPubMedCentralGoogle Scholar
- WHO (2013) Collaborating centre for drug statistics methodology. Guidelines for ATC classification and DDD assignment 2014, OsloGoogle Scholar