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Abstract

Background: Determining the incidence, progression, and patterns of multimorbidityare important for the prevention, management, and treatment of concurrence of multipleconditions. This study aimed to analyzemajormultimorbidity patterns and the associationof the onset of a primary condition or combinations of a primary and a secondarycondition with the progression to subsequent conditions. Methods: We included 53,867 participants aged 45–64 years from the 45 and UpStudy who were free of 10 predefined chronic conditions at baseline (2006–2009). Theincidence of multimorbidity (coexistence of 2, 3, and 4 conditions) was identifiedusing the claims database until December 31, 2016. The primary, secondary, tertiary,and quaternary condition for each participant was defined according to its temporal orderof onset. Results: During a mean 9-years follow-up, the cumulative incidence of primary,secondary, tertiary, and quaternary conditions was 49.6, 23.7, 9.0, and 2.9%,respectively. The time to develop a subsequent condition decreased with theaccumulation of conditions (P Conclusions: A high incidence of multimorbidity in middle-aged adults was observedand CMDs were most commonly seen in multimorbidity patterns. There may beaccelerated aging after a primary condition occurs. Our findings also reveal a potentialpreventative window to obviate the development of secondary or tertiary conditions.

Item Type:	Article
Authors/Creators:	Shang, X and Peng, W and Hill, E and Szoeke, C and He, M and Zhang, L
Keywords:	multimorbidity, epidemiology, patterns, disease, patterns of multimorbidity, time to develop subsequent conditions, primary condition, secondary condition, tertiary condition, quaternary condition
Journal or Publication Title:	Frontiers in Public Health
Publisher:	Frontiers Research Foundation
ISSN:	2296-2565
DOI / ID Number:	10.3389/fpubh.2020.00404
Copyright Information:	Copyright 2020 Shang, Peng, Hill, Szoeke, He and Zhang. This is an open-accessarticle distributed under the terms of the Creative Commons Attribution License (CC BY).
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