title: Multimorbidity and associated factors in Brazilian women aged 40 to 65 years:  a population-based study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the presence of multimorbidity and associated factors in Brazilian women aged 40 to 65 years with 11 or more years of school education.
  
  
  METHODS
  A secondary analysis of a cross-sectional population-based study was conducted using an anonymous self-report questionnaire completed by 377 women. The number of reported morbid conditions was evaluated (depression, hypertension, diabetes mellitus, urinary incontinence, and insomnia) and classified as none or one and two or more morbid conditions. The sociodemographic, behavioral, clinical, and reproductive factors associated with these conditions were also assessed. The χ test and multiple logistic regression analysis with stepwise selection criteria were used to select the major factors associated with morbid conditions, with a significance level set at 5%.
  
  
  RESULTS
  Insomnia was reported by 38.5%, depression by 31%, hypertension by 28.4%, urinary incontinence by 23.2%, and diabetes by 6.3% of the participants. In this sample, 28.9% did not report any morbid conditions, 31.8% reported one morbid condition, and 39.3% reported two or more morbid conditions. On logistic regression analysis, the increased likelihood of having two or more morbid conditions was associated with bad/fair self-perception of health (increased 5.1 times; 95% CI, 1.85-14.1), nonperformance of physical activity (increased by 2.7 times; 95% CI, 1.08-6.81), obesity (increased by 30.3 times; 95% CI, 3.17-250), postmenopause (increased by 4.4 times; 95% CI, 1.57-12.11), and nervousness (increased by 3.8 times; 95% CI, 1.45-9.8).
  
  
  CONCLUSIONS
  A worse self-perception of health, sedentariness, obesity, nervousness, and being postmenopausal were associated with multimorbidity.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
authors.forename: Vanessa
authors.initials: V
authors.lastname: de Souza Santos Machado
authors.forename: Ana Lúcia Ribeiro
authors.initials: AL
authors.lastname: Valadares
authors.forename: Lúcia Simões
authors.initials: LS
authors.lastname: da Costa-Paiva
authors.forename: Sirley S
authors.initials: SS
authors.lastname: Moraes
authors.forename: Aarão Mendes
authors.initials: AM
authors.lastname: Pinto-Neto
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D016015:Logistic Models; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications; D017698:Postmenopause; D012649:Self Concept; D057566:Self Report; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology*; D014549:Urinary Incontinence / Q000150:complications / Q000453:epidemiology*