Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study

Background Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. Methods We identified patterns of longitudinal multimorbidity accumulation using 30 years o...

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Veröffentlicht in:Journal of comorbidity Jg. 14; S. 26335565241242277
Hauptverfasser: Bowling, C Barrett, Faldowski, Richard A, Sloane, Richard, Pieper, Carl, Brown, Tyson H, Dooley, Erin E, Burrows, Brett T, Allen, Norrina B, Gabriel, Kelley Pettee, Lewis, Cora E
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London, England SAGE Publications 01.03.2024
Sage Publications Ltd
SAGE Publishing
Schlagworte:
Cardiovascular disease
Chronic illnesses
Comorbidity
Middle age
Young adults
chronic disease
Multimorbidity
life course
ISSN:2633-5565, 2633-5565, 2235-042X
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Zusammenfassung:Background Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. Methods We identified patterns of longitudinal multimorbidity accumulation using 30 years of data from in-person exams, annual follow-ups, and adjudicated end-points among 4,945 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Chronic conditions included arthritis, asthma, atrial fibrillation, cancer, end stage renal disease, chronic obstructive pulmonary disease, coronary heart disease, diabetes, heart failure, hyperlipidemia, hypertension, and stroke. Trajectory patterns were identified using latent class growth curve models. Results Mean age (SD) at baseline (1985-6) was 24.9 (3.6), 55% were female, and 51% were Black. The median follow-up was 30 years (interquartile range 25-30). We identified six trajectory classes characterized by when conditions began to accumulate and the rapidity of accumulation: (1) early-fifties, slow, (2) mid-forties, fast, (3) mid-thirties, fast, (4) late-twenties, slow, (5) mid-twenties, slow, and (6) mid-twenties, fast. Compared with participants in the early-fifties, slow trajectory class, participants in mid-twenties, fast were more likely to be female, Black, and currently smoking and had a higher baseline mean waist circumference (83.6 vs. 75.6 cm) and BMI (27.0 vs. 23.4 kg/m2) and lower baseline physical activity (414.1 vs. 442.4 exercise units). Conclusions A life course approach that recognizes the heterogeneity in patterns of accumulation of chronic conditions from early adulthood into middle age could be helpful for identifying high risk subgroups and developing approaches to delay multimorbidity progression.
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ISSN:2633-5565
2633-5565
2235-042X
DOI:10.1177/26335565241242277