Causes and consequences of comorbidity: A review

Gijsen, Ronald; Hoeymans, Nancy; Schellevis, François G.; Ruwaard, Dirk; Satariano, William A.; van den Bos, Geertrudis A.M.

« Previous Next »Journal of Clinical Epidemiology
Volume 54, Issue 7 , Pages 661-674, July 2001

Causes and consequences of comorbidity:

A review

Ronald Gijsen
- National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
- Corresponding author. Tel.: +31 30 2743950; fax: +31 30 2744450.(R. Gijsen)
Nancy Hoeymans
- National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
François G. Schellevis
- Netherlands Institute of Primary Health Care (NIVEL), Utrecht, The Netherlands
Dirk Ruwaard
- National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
William A. Satariano
- School of Public Health, University of California at Berkeley, Berkeley CA, USA
Geertrudis A.M. van den Bos
- National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
- Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

Received 8 September 1999; received in revised form 5 October 2000; accepted 14 November 2000.

Abstract

A literature search was carried out to identify and summarize the existing information on causes and consequences of comorbidity of chronic somatic diseases. A selection of 82 articles met our inclusion criteria. Very little work has been done on the causes of comorbidity. On the other hand, much work has been done on consequences of comorbidity, although comorbidity is seldom the main subject of study. We found comorbidity in general to be associated with mortality, quality of life, and health care. The consequences of specific disease combinations, however, depended on many factors. We recommend more etiological studies on shared risk factors, especially for those comorbidities that occur at a higher rate than expected. New insights in this field can lead to better prevention strategies. Health care workers need to take comorbid diseases into account in monitoring and treating patients. Future studies on consequences of comorbidity should investigate specific disease combinations.

Keywords: Comorbidity, Chronic diseases, Etiology, Mortality, Quality of life, Health care