Time Trends in Prevalence of Chronic Diseases and Multimorbidity Not Only Due to Aging: Data from General Practices and Health Surveys

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Aug 3

PMID 27482903

Citations 127

Authors

Sandra H van Oostrom

Ronald Gijsen

Irina Stirbu

Joke C Korevaar

Francois G Schellevis

H Susan J Picavet

Nancy Hoeymans

Affiliations

Soon will be listed here.

Abstract

Introduction: Chronic diseases and multimorbidity are common and expected to rise over the coming years. The objective of this study is to examine the time trend in the prevalence of chronic diseases and multimorbidity over the period 2001 till 2011 in the Netherlands, and the extent to which this can be ascribed to the aging of the population.

Methods: Monitoring study, using two data sources: 1) medical records of patients listed in a nationally representative network of general practices over the period 2002-2011, and 2) national health interview surveys over the period 2001-2011. Regression models were used to study trends in the prevalence-rates over time, with and without standardization for age.

Results: An increase from 34.9% to 41.8% (p<0.01) in the prevalence of chronic diseases was observed in the general practice registration over the period 2004-2011 and from 41.0% to 46.6% (p<0.01) based on self-reported diseases over the period 2001-2011. Multimorbidity increased from 12.7% to 16.2% (p<0.01) and from 14.3% to 17.5% (p<0.01), respectively. Aging of the population explained part of these trends: about one-fifth based on general practice data, and one-third for chronic diseases and half of the trend for multimorbidity based on health surveys.

Conclusions: The prevalence of chronic diseases and multimorbidity increased over the period 2001-2011. Aging of the population only explained part of the increase, implying that other factors such as health care and society-related developments are responsible for a substantial part of this rise.

Citing Articles

Association between nap time, nighttime sleep, and multimorbidity in Chinese older adults: a cross-sectional study.

Song Y, Chen L, Liu Y BMC Geriatr. 2025; 25(1):151.

PMID: 40045201 PMC: 11881392. DOI: 10.1186/s12877-025-05807-x.

Multimorbidity patterns and influencing factors in older Chinese adults: a national population-based cross-sectional survey.

Xue X, Wang Z, Qi Y, Chen N, Zhao K, Zhao M J Glob Health. 2025; 15:04051.

PMID: 39981636 PMC: 11843521. DOI: 10.7189/jogh.15.04051.

Barriers and facilitators to the implementation of the Assessment of Burden of Chronic Conditions tool in Dutch primary care: a context analysis.

Claessens D, Boudewijns E, Vervloet M, Keijsers L, Gidding-Slok A, van Schayck O BMJ Open. 2025; 15(1):e087197.

PMID: 39833000 PMC: 11751986. DOI: 10.1136/bmjopen-2024-087197.

The diabetes mellitus comorbidity index in European Union member states based on the 2019 European Health Interview Survey.

Kovacs N, Mahrouseh N, Monasta L, Andreella A, Campostrini S, Varga O Sci Rep. 2025; 15(1):512.

PMID: 39747538 PMC: 11695628. DOI: 10.1038/s41598-024-84374-4.

The Prevalence of Comorbidities in Individuals with Periodontitis in a Private Periodontal Referral Practice.

Beukers N, Loos B, van der Heijden G, Stamatelou E, Angelakis A, Su N J Clin Med. 2024; 13(23).

PMID: 39685868 PMC: 11642081. DOI: 10.3390/jcm13237410.

References

Bertakis K, Azari R, Helms L, CALLAHAN E, Robbins J . Gender differences in the utilization of health care services. J Fam Pract. 2000; 49(2):147-52. View

OHalloran J, Miller G, Britt H . Defining chronic conditions for primary care with ICPC-2. Fam Pract. 2004; 21(4):381-6. DOI: 10.1093/fampra/cmh407. View

Biermans M, Verheij R, de Bakker D, Zielhuis G, de Vries Robbe P . Estimating morbidity rates from electronic medical records in general practice. Evaluation of a grouping system. Methods Inf Med. 2008; 47(2):98-106. View

Schram M, Frijters D, van de Lisdonk E, Ploemacher J, de Craen A, de Waal M . Setting and registry characteristics affect the prevalence and nature of multimorbidity in the elderly. J Clin Epidemiol. 2008; 61(11):1104-12. DOI: 10.1016/j.jclinepi.2007.11.021. View

Uijen A, van de Lisdonk E . Multimorbidity in primary care: prevalence and trend over the last 20 years. Eur J Gen Pract. 2008; 14 Suppl 1:28-32. DOI: 10.1080/13814780802436093. View

Glynn L, Valderas J, Healy P, Burke E, Newell J, Gillespie P . The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Fam Pract. 2011; 28(5):516-23. DOI: 10.1093/fampra/cmr013. View

Bussche H, Schon G, Kolonko T, Hansen H, Wegscheider K, Glaeske G . Patterns of ambulatory medical care utilization in elderly patients with special reference to chronic diseases and multimorbidity--results from a claims data based observational study in Germany. BMC Geriatr. 2011; 11:54. PMC: 3180370. DOI: 10.1186/1471-2318-11-54. View

Remington P, Brownson R . Fifty years of progress in chronic disease epidemiology and control. MMWR Suppl. 2011; 60(4):70-7. View

Erler A, Bodenheimer T, Baker R, Goodwin N, Spreeuwenberg C, Vrijhoef H . Preparing primary care for the future - perspectives from the Netherlands, England, and USA. Z Evid Fortbild Qual Gesundhwes. 2011; 105(8):571-80. DOI: 10.1016/j.zefq.2011.09.029. View

10.

Fortin M, Stewart M, Poitras M, Almirall J, Maddocks H . A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med. 2012; 10(2):142-51. PMC: 3315131. DOI: 10.1370/afm.1337. View

11.

Freid V, Bernstein A, Bush M . Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years. NCHS Data Brief. 2012; (100):1-8. View

12.

Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D . Financial crisis, austerity, and health in Europe. Lancet. 2013; 381(9874):1323-31. DOI: 10.1016/S0140-6736(13)60102-6. View

13.

Hulsegge G, Picavet H, Blokstra A, Nooyens A, Spijkerman A, van der Schouw Y . Today's adult generations are less healthy than their predecessors: generation shifts in metabolic risk factors: the Doetinchem Cohort Study. Eur J Prev Cardiol. 2013; 21(9):1134-44. DOI: 10.1177/2047487313485512. View

14.

Ward B, Schiller J . Prevalence of multiple chronic conditions among US adults: estimates from the National Health Interview Survey, 2010. Prev Chronic Dis. 2013; 10:E65. PMC: 3652717. DOI: 10.5888/pcd10.120203. View

15.

Hoeymans N, Gijsen R, Slobbe L . [59 important health problems; a selection of diseases for public health monitoring]. Ned Tijdschr Geneeskd. 2013; 157(31):A5994. View

16.

Erdem E . Prevalence of chronic conditions among Medicare Part A beneficiaries in 2008 and 2010: are Medicare beneficiaries getting sicker?. Prev Chronic Dis. 2014; 11:130118. PMC: 3899849. DOI: 10.5888/pcd11.130118. View

17.

van Oostrom S, Picavet H, de Bruin S, Stirbu I, Korevaar J, Schellevis F . Multimorbidity of chronic diseases and health care utilization in general practice. BMC Fam Pract. 2014; 15:61. PMC: 4021063. DOI: 10.1186/1471-2296-15-61. View

18.

Galenkamp H, Huisman M, Braam A, Schellevis F, Deeg D . Disease prevalence based on older people's self-reports increased, but patient-general practitioner agreement remained stable, 1992-2009. J Clin Epidemiol. 2014; 67(7):773-80. DOI: 10.1016/j.jclinepi.2014.02.002. View

19.

Merkus S, Holte K, Huysmans M, van Mechelen W, van der Beek A . Nonstandard working schedules and health: the systematic search for a comprehensive model. BMC Public Health. 2015; 15:1084. PMC: 4618954. DOI: 10.1186/s12889-015-2407-9. View

20.

Meinow B, Parker M, Kareholt I, Thorslund M . Complex health problems in the oldest old in Sweden 1992-2002. Eur J Ageing. 2017; 3(2):98-106. PMC: 5546262. DOI: 10.1007/s10433-006-0027-z. View