Understanding the Evolution of Multimorbidity: Evidences from the North West Adelaide Health Longitudinal Study (NWAHS)

Objective: The aim of this study is to describe the evolution of multimorbidity. Study Design and Setting: Data from 1854 South Australians who participated in the North West Adelaide longitudinal Health Study(NWAHS) was collected between baseline (2000-2002) and follow-up (2008-2010). Status for eight chronic diseases (CDs) was determined by biomedical measurement or self-report. Chronic disease (CD) mean age of occurrence and order of appearance was investigated. Results: The prevalence of multimorbidity increased from 32% to 64% during the 7.8 +/- 1.1 years of follow-up. The estimated mean age of onset of a new CD was significantly older for hypertension, cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) and younger for hypercholesterolemia, asthma and other mental problem. Hypercholesterolemia was more likely to develop as a first than as a subsequent CD (39%vs. 16%, p<0.0001) while CVD (1%vs. 5%, p<0.0001), diabetes (5%vs. 11%, p<0.001) and COPD (6%vs. 16%, p<0.0001) were less likely. The presence of mood disorders at baseline was associated with an increased risk of developing other mental disorders (36%vs. 12%, p<0.0001), diabetes (18%vs. 9%, p<0.01) and asthma (30%vs. 21%, p<0.05). Conclusion: Longitudinal data could be used to study the evolution of multimorbidity and could provide information on CDs mean age of occurrence, order of appearance and impact on the development of future CDs.