Multimorbidity in adults from a southern Brazilian city: occurrence and patterns.
OBJECTIVE
The aim of this study was to evaluate occurrences and patterns of multimorbidity in adults from a southern Brazilian city.


METHODS
A population-based cross-sectional study was carried out in 2012 through face-to-face interviews with adults (20 or more years) living in Pelotas, southern Brazil. Multimorbidity was evaluated by a list of 11 morbidities (based on medical diagnosis; Patient Health Questionnaire 9 for depression; and Anatomical Therapeutic Chemical index) and operationalized according to two cutoff points: ≥2 and ≥3 morbidities. Descriptive analysis and factor analysis (FA) were performed.


RESULTS
The sample was made up of 2927 adults. Multimorbidity reached 29.1 % (95 % CI: 27.1; 31.1) for ≥2, and 14.3 % (95 % CI: 12.8; 15.8) for ≥3 morbidities and was greater in females, older people, those with less schooling and those from lower economic classes. Four pairs (frequency ≥5 %) and four triplets (frequency ≥2 %) were observed. Two patterns of morbidities (cardiometabolic and joint problems; and respiratory diseases) explained 93 % of total variance.


CONCLUSIONS
Multimorbidity was common in the studied population. The observed patterns may be used to generate and improve Brazilian diseases guidelines.
Department of Nursing, Federal University of Pelotas, Pelotas, Brazil. nunesbp@gmail.com.|Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. nunesbp@gmail.com.
Bruno Pereira
BP
Nunes
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.|School of Nursing, Universidad Industrial de Santander, Bucaramanga, Colombia.
Fabio Alberto
FA
Camargo-Figuera
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Marília
M
Guttier
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Paula Duarte
PD
de Oliveira
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Tiago N
TN
Munhoz
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.|Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Alicia
A
Matijasevich
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Andréa Dâmaso
AD
Bertoldi
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Fernando César
FC
Wehrmeister
Department of Physiology and Pharmacology, Institute of Biology, Federal University of Pelotas, Pelotas, Brazil.
Marysabel Pinto Telis
MP
Silveira
Department of Nursing, Postgraduate Program in Nursing, Federal University of Pelotas, Pelotas, Brazil.
Elaine
E
Thumé
Department of Social Medicine, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.|Department of Nursing, Postgraduate Program in Nursing, Federal University of Pelotas, Pelotas, Brazil.
Luiz Augusto
LA
Facchini
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult
Brazil; Chronic diseases; Comorbidity; Elderly; Multimorbidity; Statistical disease clustering