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. 2018 Oct 25;52Suppl 2(Suppl 2):10s.
doi: 10.11606/S1518-8787.2018052000637.

Multimorbidity: The Brazilian Longitudinal Study of Aging (ELSI-Brazil)

[Article in English, Portuguese]
Bruno Pereira Nunes  1 , Sandro Rogério Rodrigues Batista  2 , Fabíola Bof de Andrade  3   4 , Paulo Roberto Borges de Souza Junior  5 , Maria Fernanda Lima-Costa  3   4 , Luiz Augusto Facchini  6
Affiliations

Multimorbidity: The Brazilian Longitudinal Study of Aging (ELSI-Brazil)

[Article in English, Portuguese]
Bruno Pereira Nunes et al. Rev Saude Publica. .

Abstract
in English, Portuguese

Objective: To evaluate the occurrence and factors associated with multimorbidity among Brazilians aged 50 years and over.

Methods: This is a cross-sectional study in a nation-based cohort of the non-institutionalized population in Brazil. Data were collected between 2015 and 2016. Multimorbidity was assessed from a list of 19 morbidities, which were categorized into ≥ 2 and ≥ 3 diseases. The analysis included the calculation of frequencies and the most frequent 10 pairs and triplets of combinations of diseases. The crude and adjusted analyses evaluated the demographic, socioeconomic, behavioral, and contextual variables (area of residence, geopolitical region, and coverage of the Family Health Strategy) using Poisson regression.

Results: From the total of 9,412 individuals, 67.8% (95%CI 65.6-69.9) and 47.1% (95%CI 44.8-49.4) showed ≥ 2 and ≥ 3 diseases, respectively. In the adjusted analysis, women, older persons, and those who did not consume alcohol had increased multimorbidity. There were no associations with race, area of residence, geopolitical region, and coverage of the Family Health Strategy. The 10 pairs (frequencies observed between 11.6% and 23.2%) and the 10 triplets (frequencies observed between 4.9% and 9.5%) of the most frequent diseases mostly included back problems (15 times) and systemic arterial hypertension (11 times). All combinations were statistically higher than expected by chance.

Conclusions: The occurrence of multimorbidity was high even among younger individuals (50 to 59 years). Approximately two in three (≥ 2 diseases) and one in two (≥ 3 diseases) individuals aged 50 years and over presented multimorbidity, which represents 26 and 18 million persons in Brazil, respectively. We observed high frequencies of combinations of morbidities.

OBJETIVO: Avaliar a ocorrência e os fatores associados à multimorbidade entre brasileiros com 50 anos ou mais de idade.

MÉTODOS: Estudo transversal em uma coorte de base nacional da população brasileira não institucionalizada. Os dados foram coletados entre 2015 e 2016. A multimorbidade foi avaliada a partir de uma lista de 19 morbidades, sendo categorizada em ≥ 2 e ≥ 3 doenças. A análise incluiu cálculo de frequências e 10 pares e trios mais frequentes de combinações de doenças, além das análises bruta e ajustada dos fatores associados por meio de regressão de Poisson, incluindo variáveis demográficas, socioeconômicas, comportamentais e contextuais (zona de residência, região geopolítica e cobertura da Estratégia Saúde da Família).

RESULTADOS: Do total de 9.412 indivíduos, 67,8% (IC95% 65,6–69,9) e 47,1% (IC95% 44,8–49,4) tinham ≥ 2 e ≥ 3 doenças, respectivamente. Na análise ajustada, mulheres, pessoas mais velhas e aqueles que não consumiam bebidas alcoólicas tiveram mais multimorbidade. Não foram observadas associações com cor da pele, zona de residência, região geopolítica e cobertura da Estratégia Saúde da Família. Os 10 pares (frequências observadas entre 11,6% e 23,2%) e os 10 trios (frequências observadas entre 4,9% e 9,5%) de doenças mais frequentes incluíram, em sua maioria, problema de coluna (15 vezes) e hipertensão arterial sistêmica (11 vezes). Todas as combinações apresentaram frequência estatisticamente maior do que seria esperado ao acaso.

CONCLUSÕES: A ocorrência de multimorbidade foi elevada mesmo entre os indivíduos mais jovens (50 a 59 anos). Cerca de dois em cada três (≥ 2 doenças) e um em cada dois (≥ 3 doenças) indivíduos com 50 anos ou mais apresentaram multimorbidade, representando 26 e 18 milhões de pessoas no Brasil, respectivamente. Frequências elevadas de combinações de morbidades foram observadas.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure
Figure. Occurrence of number of morbidities according to age group. Brazilian Longitudinal Study of Aging (ELSI-Brazil), 2015–2016.
See this image and copyright information in PMC

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References

    1. Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med. 2012;10(2):142–151. https://doi.org/10.1370/afm.1337 - DOI - PMC - PubMed
    1. Harrison C, Britt H, Miller G, Henderson J. Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open. 2014;4(7):e004694. https://doi.org/10.1136/bmjopen-2013-004694 - DOI - PMC - PubMed
    1. Huntley AL, Johnson R, Purdy S, Valderas JM, Salisbury C. Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide. Ann Fam Med. 2012;10(2):134–141. https://doi.org/10.1370/afm.1363 - DOI - PMC - PubMed
    1. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37–43. https://doi.org/10.1016/S0140-6736(12)60240-2 - DOI - PubMed
    1. Fortin M, Lapointe L, Hudon C, Vanasse A, Ntetu AL, Maltais D. Multimorbidity and quality of life in primary care: a systematic review. 51Health Qual Life Outcomes. 2004;2 https://doi.org/10.1186/1477-7525-2-51 - DOI - PMC - PubMed