title: Risk of developing multimorbidity across all ages in an historical cohort study: differences by sex and ethnicity.
abstract: OBJECTIVE
  To study the incidence of de novo multimorbidity across all ages in a geographically defined population with an emphasis on sex and ethnic differences.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  All persons residing in Olmsted County, Minnesota, USA on 1 January 2000 who had granted permission for their records to be used for research (n=123 716).
  
  
  METHODS
  We used the Rochester Epidemiology Project medical records-linkage system to identify all of the county residents. We identified and removed from the cohort all persons who had developed multimorbidity before 1 January 2000 (baseline date), and we followed the cohort over 14 years (1 January 2000 through 31 December 2013).
  
  
  METHODS
  Incident multimorbidity was defined as the development of the second of 2 conditions (dyads) from among the 20 chronic conditions selected by the US Department of Health and Human Services. We also studied the incidence of the third of 3 conditions (triads) from among the 20 chronic conditions.
  
  
  RESULTS
  The incidence of multimorbidity increased steeply with older age; however, the number of people with incident multimorbidity was substantially greater in people younger than 65 years compared to people age 65 years or older (28 378 vs 6214). The overall risk was similar in men and women; however, the combinations of conditions (dyads and triads) differed extensively by age and by sex. Compared to Whites, the incidence of multimorbidity was higher in Blacks and lower in Asians.
  
  
  CONCLUSIONS
  The risk of developing de novo multimorbidity increases steeply with older age, varies by ethnicity and is similar in men and women overall. However, as expected, the combinations of conditions vary extensively by age and sex. These data represent an important first step toward identifying the causes and the consequences of multimorbidity.
authors: Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA The Robert D and Patricia E Kern Center for the Science of Health Care Delivery, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Jennifer L
authors: JL
authors: St Sauver
authors: Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors: Cynthia M
authors: CM
authors: Boyd
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Brandon R
authors: BR
authors: Grossardt
authors: Department of Psychiatry and Psychology, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: William V
authors: WV
authors: Bobo
authors: Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA The Robert D and Patricia E Kern Center for the Science of Health Care Delivery, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Lila J
authors: LJ
authors: Finney Rutten
authors: Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA The Robert D and Patricia E Kern Center for the Science of Health Care Delivery, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA Division of Cardiovascular Diseases, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Véronique L
authors: VL
authors: Roger
authors: The Robert D and Patricia E Kern Center for the Science of Health Care Delivery, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Jon O
authors: JO
authors: Ebbert
authors: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Terry M
authors: TM
authors: Therneau
authors: Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA Department of Research, Olmsted Medical Center, Rochester, Minnesota, USA.
authors: Barbara P
authors: BP
authors: Yawn
authors: Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA Department of Neurology, College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Walter A
authors: WA
authors: Rocca
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D044383:Black People; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D044465:White People; D055815:Young Adult; D001741:Black or African American
keywords: EPIDEMIOLOGY; GENERAL MEDICINE (see Internal Medicine); GERIATRIC MEDICINE; PREVENTIVE MEDICINE; PRIMARY CARE
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