Journal of Clinical Epidemiology
Volume 61, Issue 11 , Pages 1104-1112, November 2008

Setting and registry characteristics affect the prevalence and nature of multimorbidity in the elderly

  • Miranda T. Schram

      Affiliations

    • Extramural Medicine (EMGO institute), VU University Medical Center, Amsterdam
  • ,
  • Dinnus Frijters

      Affiliations

    • Extramural Medicine (EMGO institute), VU University Medical Center, Amsterdam
  • ,
  • Eloy H. van de Lisdonk

      Affiliations

    • Department of General Practice, Radboud University Nijmegen Medical Center, Nijmegen
  • ,
  • Janneke Ploemacher

      Affiliations

    • Statistics Netherlands, Voorburg
  • ,
  • Anton J.M. de Craen

      Affiliations

    • Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden
  • ,
  • Margot W.M. de Waal

      Affiliations

    • Department of Public Health and Primary Care, Leiden University Medical Center, Leiden
  • ,
  • Frank J. van Rooij

      Affiliations

    • Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam
  • ,
  • Jan Heeringa

      Affiliations

    • Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam
  • ,
  • Albert Hofman

      Affiliations

    • Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam
  • ,
  • Dorly J.H. Deeg

      Affiliations

    • Extramural Medicine (EMGO institute), VU University Medical Center, Amsterdam
    • Corresponding Author InformationCorresponding author. LASA, Institute for Research in Extramural Medicine (EMGO-Institute), VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Tel.: +31-20–4446770; fax: +31-20–4446775.
  • ,
  • Francois G. Schellevis

      Affiliations

    • Extramural Medicine (EMGO institute), VU University Medical Center, Amsterdam
    • Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands

Accepted 30 November 2007. published online 09 June 2008.

Abstract 

Objective

The aim of the study was to investigate how settings and registry characteristics affect the prevalence and nature of multimorbidity in elderly individuals.

Study Design and Setting

We used data from three population-based studies, two general practitioner registries, one hospital discharge register, and one nursing home registry to estimate the prevalence of multimorbidity. Individuals aged 55 years and over were included.

Results

Multimorbidity was most prevalent in nursing homes (82%), followed by the general population and general practitioner registries (56%–72%) and the hospital setting (22%). There were large differences in the nature of multimorbidity between settings. Combinations of hypertension, heart disease, and osteoarthritis were dominant in the population-based setting, whereas hypertension in combination with osteoarthritis, obesity, disorders of lipid metabolism, and diabetes dominated in the general practitioner setting. In the hospital setting, combinations of heart diseases had the highest prevalence. Combinations of dementia, hypertension, and stroke were dominant within the nursing home setting.

Conclusion

This study shows that setting and registry characteristics have an important influence on the outcome of multimorbidity studies. We recommend provision of at least information about the setting, the (list of) conditions included, the data collection method, and the time frame used, when reporting about the size and nature of multimorbidity.

Keywords: Multimorbidity, Prevalence, Chronic diseases, General population, Health care, Methodology

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PII: S0895-4356(07)00457-X

doi:10.1016/j.jclinepi.2007.11.021

Journal of Clinical Epidemiology
Volume 61, Issue 11 , Pages 1104-1112, November 2008