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Multimorbidity in South Asian adults: prevalence, risk factors and mortality.
Journal of Public Health (Oxford)
  • Kalpana Singh, Public Health Foundation of India
  • Shivani A. Patel, Emory University
  • Suddhendu Biswas, Amity University
  • Roopa Shivashankar, Emory University
  • Dimple Kondal, Centre for Chronic Disease Control
  • Vamadevan Ajay, Centre for Chronic Disease Control
  • Ranjit Mohan Anjana, Madras Diabetes Research Foundation
  • Zafar Fatmi, Aga Khan University
  • Mohammed K. Ali, Emory University
  • Muhammad Masood Kadir, Aga Khan Unviversity
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We report the prevalence, risk factors and mortality associated with multimorbidity in urban South Asian adults. Methods:

Hypertension, diabetes, heart disease, stroke and chronic kidney disease were measured at baseline in a sample of 16 287 adults ages ≥20 years in Delhi, Chennai and Karachi in 2010-11 followed for an average of 38 months. Multimorbidity was defined as having ≥2 chronic conditions at baseline. We identified correlates of multimorbidity at baseline using multinomial logistic models, and we assessed the prospective association between multimorbidity and mortality using Cox proportional hazards models. Results:

The adjusted prevalence of multimorbidity was 9.4%; multimorbidity was highest in adults who were aged ≥60 years (37%), consumed alcohol (12.3%), body mass index ≥25 m/kg2 (14.1%), high waist circumference (17.1%) and had family history of a chronic condition (12.4%). Compared with adults with no chronic conditions, the fully adjusted relative hazard of death was twice as high in adults with two morbidities (hazard ratio [HR] = 2.3; 95% confidence interval [CI]: 1.6, 3.3) and thrice as high in adults with ≥3 morbidities (HR = 3.1; 95% CI: 1.9, 5.1). Conclusion:

Multimorbidity affects nearly 1 in 10 urban South Asians, and each additional morbidity carries a progressively higher risk of death. Identifying locally appropriate strategies for prevention and coordinated management of multimorbidity will benefit population health in the region.

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Citation Information
Kalpana Singh, Shivani A. Patel, Suddhendu Biswas, Roopa Shivashankar, et al.. "Multimorbidity in South Asian adults: prevalence, risk factors and mortality." Journal of Public Health (Oxford) (2018)
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