Lifestyle and Socioeconomic Determinants of Multimorbidity Patterns among Mid-Aged Women: A Longitudinal Study.
BACKGROUND
Little is known about patterns of associative multimorbidity and their aetiology. We aimed to identify patterns of associative multimorbidity among mid-aged women and the lifestyle and socioeconomic factors associated with their development.


METHODS
Participants were from the Australian Longitudinal Study on Women's Health. We included 4896 women born 1946-51, without multimorbidity in 1998. We identified multimorbidity patterns at survey 6 (2010) using factor analysis, and related these patterns to baseline lifestyle and socioeconomic factors using logistic regression. We dichotomised factor scores and determined odds ratios (ORs) with 95% confidence intervals (CIs) for associations between characteristics and odds of a high versus low factor score.


RESULTS
We identified five multimorbidity patterns: psychosomatic; musculoskeletal; cardiometabolic; cancer; and respiratory. Overweight and obesity were respectively associated with increased odds of having a high score for the musculoskeletal (adjusted ORs 1.45 [95% CI 1.23, 1.70] and 2.14 [95% CI 1.75, 2.60]) and cardiometabolic (adjusted ORs 1.53 [95% CI 1.31, 1.79] and 2.46 [95% CI 2.02, 2.98]) patterns. Physical inactivity was associated with increased odds of a high score for the psychosomatic, musculoskeletal and cancer patterns (adjusted ORs 1.41 [95% CI 1.13, 1.76]; 1.39 [95% CI 1.11, 1.74]; and 1.35 [95% CI 1.08, 1.69]). Smoking was associated with increased odds of a high score for the respiratory pattern. Education and ability to manage on income were associated with increased odds of a high score for the psychosomatic pattern (adjusted ORs 1.34 [95% CI 1.03, 1.75] and 1.73 [95% CI 1.37, 1.28], respectively) and musculoskeletal pattern (adjusted ORs 1.43 [95% CI 1.10, 1.87] and 1.38 [1.09, 1.75], respectively).


CONCLUSIONS
Distinct multimorbidity patterns can be identified among mid-aged women. Social inequality, physical activity and BMI are risk factors common to multiple patterns and are appropriate targets for reducing the risk of specific multimorbidity groups in mid-life women.
Centre for Longitudinal and Life course Research, School of Population Health, University of Queensland, Herston Road, Herston, QLD 4006,Australia.|Usher Institute of Population Health Sciences and Informatics, No. 9 Edinburgh Bioquarter, 9 Little France Road, Edinburgh, EH16 4UX, United Kingdom.
Caroline A
CA
Jackson
Centre for Longitudinal and Life course Research, School of Population Health, University of Queensland, Herston Road, Herston, QLD 4006,Australia.
Annette J
AJ
Dobson
Centre for Longitudinal and Life course Research, School of Population Health, University of Queensland, Herston Road, Herston, QLD 4006,Australia.
Leigh R
LR
Tooth
Centre for Longitudinal and Life course Research, School of Population Health, University of Queensland, Herston Road, Herston, QLD 4006,Australia.
Gita D
GD
Mishra
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors