Prevalence and Risk Factors of the Most Common Multimorbidity Among Canadian Adults

Overview

Journal PLoS One

Date 2025 Jan 22

PMID 39841682

Authors

Obed Mortey

Gerald Mugford

Kris Aubrey-Bassler

Hensley H Mariathas

Ugochukwu Odimba

Zhiwei Gao

Affiliations

Soon will be listed here.

Abstract

Background: The number of persons living with multimorbidity-defined as the co-occurrence of at least two chronic conditions in the same individual-is growing globally, especially in developed countries. Traditionally, this increase has been attributed to a growing aging population, sedentary lifestyle, obesity, low socioeconomic status, and individual genetic susceptibility.

Objective: To investigate the prevalence and associated risk factors of the most common multimorbidity (MCM) among Canadian middle-aged and older adults.

Method: Relevant data on all 30,097 middle-aged and older Canadian adults (aged 45 to 85 years) from the Canadian Longitudinal Study on Aging were used for this study. To identify the specific sociodemographic risk factors associated with the MCM, we used survey-specific logistic regression.

Findings: Overall, co-occurrence of osteoarthritis and hypertension was identified as the MCM among Canadian adults aged 45+ with an estimated prevalence of 16.5%. The results from multivariate analysis showed that seven factors were significantly associated with increased odds of the MCM, which included increasing age, being retired from work (retired vs not retired), poorer rating of perceived health, (very good, good, poor vs excellent), increasing problems with sleep quality (satisfied, dissatisfied vs neutral), and abnormal body-mass index (underweight, overweight, obese vs normal). Also, residents in other urban centres had significantly lower odds than those in urban core. Persons living in Atlantic Canada, Ontario and Quebec were at increased odds of having the MCM compared to those in British Columbia. The odds of the MCM associated with increasing age was significantly higher among Females (OR = 1.12, 95% CI = 1.11-1.13) than Males (OR = 1.08, 95% CI = 1.07-1.10).

Conclusion: Multimorbidity is a common feature among Canadian adults. The identification of the most prevalent patterns and associated risk factors in this study provides fresh insights into the etiology, progression, and possible prevention of the MCM among Canadian adults.

References

Gondek D, Bann D, Brown M, Hamer M, Sullivan A, Ploubidis G . Prevalence and early-life determinants of mid-life multimorbidity: evidence from the 1970 British birth cohort. BMC Public Health. 2021; 21(1):1319. PMC: 8317357. DOI: 10.1186/s12889-021-11291-w. View

Yao S, Cao G, Han L, Chen Z, Huang Z, Gong P . Prevalence and Patterns of Multimorbidity in a Nationally Representative Sample of Older Chinese: Results From the China Health and Retirement Longitudinal Study. J Gerontol A Biol Sci Med Sci. 2019; 75(10):1974-1980. DOI: 10.1093/gerona/glz185. View

Roberts K, Rao D, Bennett T, Loukine L, Jayaraman G . Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada. Health Promot Chronic Dis Prev Can. 2015; 35(6):87-94. PMC: 4910465. DOI: 10.24095/hpcdp.35.6.01. View

Perruccio A, Katz J, Losina E . Health burden in chronic disease: multimorbidity is associated with self-rated health more than medical comorbidity alone. J Clin Epidemiol. 2011; 65(1):100-6. PMC: 3217092. DOI: 10.1016/j.jclinepi.2011.04.013. View

Murray C, Vos T, Lozano R, Naghavi M, Flaxman A, Michaud C . Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):2197-223. DOI: 10.1016/S0140-6736(12)61689-4. View

Bryant L, Beck A, Fairclough D . Factors that contribute to positive perceived health in an older population. J Aging Health. 2000; 12(2):169-92. DOI: 10.1177/089826430001200202. View

Loeser R . Aging and osteoarthritis. Curr Opin Rheumatol. 2011; 23(5):492-6. PMC: 3377970. DOI: 10.1097/BOR.0b013e3283494005. View

Fyhrquist F, Saijonmaa O, Strandberg T . The roles of senescence and telomere shortening in cardiovascular disease. Nat Rev Cardiol. 2013; 10(5):274-83. DOI: 10.1038/nrcardio.2013.30. View

The Lancet . Making more of multimorbidity: an emerging priority. Lancet. 2018; 391(10131):1637. DOI: 10.1016/S0140-6736(18)30941-3. View

10.

Tang J, Liu T, Wen X, Zhou Z, Yan J, Gao J . Estrogen-related receptors: novel potential regulators of osteoarthritis pathogenesis. Mol Med. 2021; 27(1):5. PMC: 7809777. DOI: 10.1186/s10020-021-00270-x. View

11.

Abad-Diez J, Calderon-Larranaga A, Poncel-Falco A, Poblador-Plou B, Calderon-Meza J, Sicras-Mainar A . Age and gender differences in the prevalence and patterns of multimorbidity in the older population. BMC Geriatr. 2014; 14:75. PMC: 4070347. DOI: 10.1186/1471-2318-14-75. View

12.

Willadsen T, Bebe A, Koster-Rasmussen R, Jarbol D, Guassora A, Waldorff F . The role of diseases, risk factors and symptoms in the definition of multimorbidity - a systematic review. Scand J Prim Health Care. 2016; 34(2):112-21. PMC: 4977932. DOI: 10.3109/02813432.2016.1153242. View

13.

Raina P, Wolfson C, Kirkland S, Griffith L, Balion C, Cossette B . Cohort Profile: The Canadian Longitudinal Study on Aging (CLSA). Int J Epidemiol. 2019; 48(6):1752-1753j. PMC: 6929533. DOI: 10.1093/ije/dyz173. View

14.

Kisely S, Asbridge M, Connor J, White A, Pais J, Lin E . Using administrative health data for the surveillance of interventions for alcohol-related harm among young people. CMAJ. 2011; 184(1):49-53. PMC: 3255209. DOI: 10.1503/cmaj.110367. View

14.

Beckett M, Weinstein M, Goldman N . Do health interview surveys yield reliable data on chronic illness among older respondents?. Am J Epidemiol. 2000; 151(3):315-23. DOI: 10.1093/oxfordjournals.aje.a010208. View

15.

Taruc-Uy R, Lynch S . Diagnosis and treatment of osteoarthritis. Prim Care. 2013; 40(4):821-36, vii. DOI: 10.1016/j.pop.2013.08.003. View

16.

Chow C, Donovan L, Manuel D, Johansen H, Tu J . Regional variation in self-reported heart disease prevalence in Canada. Can J Cardiol. 2005; 21(14):1265-71. View

17.

Ryan B, Jenkyn K, Shariff S, Allen B, Glazier R, Zwarenstein M . Beyond the grey tsunami: a cross-sectional population-based study of multimorbidity in Ontario. Can J Public Health. 2018; 109(5-6):845-854. PMC: 6964436. DOI: 10.17269/s41997-018-0103-0. View

18.

Tu K, Chen Z, Lipscombe L . Prevalence and incidence of hypertension from 1995 to 2005: a population-based study. CMAJ. 2008; 178(11):1429-35. PMC: 2374870. DOI: 10.1503/cmaj.071283. View

19.

Coppola C, Greco M, Munir A, Musaro D, Quarta S, Massaro M . Osteoarthritis: Insights into Diagnosis, Pathophysiology, Therapeutic Avenues, and the Potential of Natural Extracts. Curr Issues Mol Biol. 2024; 46(5):4063-4105. PMC: 11119992. DOI: 10.3390/cimb46050251. View