Clinical and lifestyle-related risk factors for incident multimorbidity: 10-year follow-up of Finnish population-based cohorts 1982-2012.
BACKGROUND
Multimorbidity is a huge burden to individuals and societies and more attention should be paid on its risk factors and prevention possibilities. The aim of this study was to investigate which clinical and lifestyle characteristics predict the development of multimorbidity both among initially disease-free people and among people who have diabetes or CVD.


METHODS
Data comprised 25-64 year old, randomly selected men and women (n=32,972) who participated in one of the five national FINRISK surveys between 1982 and 2002 in Finland. The surveys included anthropometric measurements, blood samples and structured questionnaire. Data on incident diagnoses of the five most common chronic diseases during 10 years were received from the national registers on mortality, hospitalizations, and reimbursement rights.


RESULTS
Predisposing factors for multimorbidity among disease-free population were smoking, physical inactivity, and BMI. Among men also systolic blood pressure and low education predicted multimorbidity. Among men with DM at baseline, high blood pressure, physical inactivity, and smoking increased the likelihood of incident multimorbidity. Among women, significant predictors of multimorbidity were high BMI and smoking. Among men and women with CVD, the only baseline factor that was significantly associated with the development of multimorbidity in the multivariate prediction model was low fruit and vegetable consumption.


CONCLUSIONS
Several modifiable clinical and lifestyle risk factors were found to predict incident multimorbidity. Better recognition and management of these risk factors could potentially have a large impact on the development of multimorbidity, and consequently, premature mortality and costs of care among the aging populations.
National Institute for Health and Welfare, Department of Chronic Disease Prevention, PO Box 30, 00271 Helsinki, Finland. Electronic address: katja.wikstrom@thl.fi.
Katja
K
Wikström
National Institute for Health and Welfare, Department of Chronic Disease Prevention, PO Box 30, 00271 Helsinki, Finland.
Jaana
J
Lindström
National Institute for Health and Welfare, Department of Chronic Disease Prevention, PO Box 30, 00271 Helsinki, Finland.
Kennet
K
Harald
National Institute for Health and Welfare, Department of Chronic Disease Prevention, PO Box 30, 00271 Helsinki, Finland.
Markku
M
Peltonen
National Institute for Health and Welfare, Department of Chronic Disease Prevention, PO Box 30, 00271 Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO Box 1627, Kuopio, Finland; Hospital District of North Karelia, Tikkamäentie 16, Joensuu, Finland.
Tiina
T
Laatikainen
D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity; D012307:Risk Factors; D064424:Tobacco Use
Cardiovascular disease; Diabetes; Multimorbidity; Risk factors