Multimorbidity and associations with clinical outcomes in a middle-aged population in Iran: a longitudinal cohort study

dc.contributor.authorMaria Lisa Odland
dc.contributor.authorSamiha Ismail
dc.contributor.authorSadaf G Sepanlou
dc.contributor.authorHossein Poustchi
dc.contributor.authorAlireza Sadjadi
dc.contributor.authorAkram Pourshams
dc.contributor.authorTom Marshall
dc.contributor.authorMiles D Witham
dc.contributor.authorReza Malekzadeh
dc.contributor.authorJustine I Davies
dc.date.accessioned2024-04-04T08:42:40Z
dc.date.available2024-04-04T08:42:40Z
dc.date.issued2022-04-19
dc.description.abstractBackground As the populations of lower-income and middle-income countries age, multimorbidity is increasing, but there is little information on its longterm consequences. We aimed to show associations between multimorbidity and outcomes of mortality and hospitalisation in Iran, a middle-income country undergoing rapid economic transition. Methods We conducted a secondary analysis of longitudinal data collected in the Golestan Cohort Study. Data on demographics, morbidities and lifestyle factors were collected at baseline, and information on hospitalisations or deaths was captured annually. Logistic regression was used to analyse the association between baseline multimorbidity and 10-year mortality, Cox-proportional hazard models to measure lifetime risk of mortality and zero-inflation models to investigate the association between hospitalisation and multimorbidity. Multimorbidity was classified as ≥2 conditions or number of conditions. Demographic, lifestyle and socioeconomic variables were included as covariables. Results The study recruited 50 045 participants aged 40–75 years between 2004 and 2008, 47 883 were available for analysis, 416 (57.3%) were female and 12 736 (27.94%) were multimorbid. The odds of dying at 10 years for multimorbidity defined as ≥2 conditions was 1.99 (95% CI 1.86 to 2.12, p<0.001), and it increased with increasing number of conditions (OR of 3.57; 95% CI 3.12 to 4.08, p<0.001 for ≥4 conditions). The survival analysis showed the hazard of death for those with ≥4 conditions was 3.06 (95% CI 2.74 to 3.43, p<0.001). The number of hospital admissions increased with number of conditions (OR of not being hospitalised of 0.36; 95% CI 0.31 to 0.52, p<0.001, for ≥4 conditions). Conclusion The long-terms effects of multimorbidity on mortality and hospitalisation are similar in this population to those seen in high-income countries.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/38305
dc.language.isoen
dc.schoolPublic Health
dc.titleMultimorbidity and associations with clinical outcomes in a middle-aged population in Iran: a longitudinal cohort study
dc.typeArticle
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