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Risk factors for multimorbidity in adulthood: a systematic review

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posted on 2023-09-13, 14:25 authored by Clare Tazzeo, Alberto Zucchelli, Davide Vetrano, Jacopo Demurtas, Lee Smith, Daniel Schoene, Dolores Sanchez-Rodriguez, Graziano Onder, Cafer Balci, Silvia Bonetti, Giulia Grande, Gabriel Torbahn, Nicola Veronese, Alessandra Marengoni

Multimorbidity, the coexistence of multiple chronic diseases in an individual, is highly prevalent and challenging for healthcare systems. However, its risk factors remain poorly understood.

Objective

To systematically review studies reporting multimorbidity risk factors.

Methods

A PRISMA-compliant systematic review was conducted, searching electronic databases (MEDLINE, EMBASE, Web of Science, Scopus). Inclusion criteria were studies addressing multimorbidity transitions, trajectories, continuous disease counts, and specific patterns. Non-human studies and participants under 18 were excluded. Associations between risk factors and multimorbidity onset were reported.

Results

Of 20,806 identified studies, 68 were included, with participants aged 18–105 from 23 countries. Nine risk factor categories were identified, including demographic, socioeconomic, and behavioral factors. Older age, low education, obesity, hypertension, depression, low pysical function were generally positively associated with multimorbidity. Results for factors like smoking, alcohol consumption, and dietary patterns were inconsistent. Study quality was moderate, with 16.2% having low risk of bias.

Conclusions

Several risk factors seem to be consistently associated with an increased risk of accumulating chronic diseases over time. However, heterogeneity in settings, exposure and outcome, and baseline health of participants hampers robust conclusions.

History

Refereed

  • Yes

Volume

91

Publication title

Ageing Research Reviews

ISSN

1568-1637

Publisher

Elsevier

File version

  • Published version

Item sub-type

Article

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  • School of Education and Social Care Outputs

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