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Epidemiology and Health 2020;e2020001.
DOI: https://doi.org/10.4178/epih.e2020001    [Accepted] Published online Dec 27, 2019.
Sociodemographic and lifestyle factors associated with multimorbidity in New Zealand
Nayyereh Aminisani1  , Christine Stephens2  , Joanne Allen2  , Fiona Alpass2  , Seyed Morteza Shamshirgaran3 
1Epidemiology and Statistics Department, Faculty of Health Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
2School of Psychology, Massey University, Palmerston North, New Zealand (Aotearoa)
3Healthy Aging Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
Correspondence  Seyed Morteza Shamshirgaran ,Tel: +989144092584, Fax: 985143306205, Email: m.shamshirgaran@hotmail.com
Received: Aug 3, 2019  Accepted after revision: Dec 27, 2019
The incidence of multimorbidity (MM) and its correlates among older adults remain poorly defined. This study aimed to examine the sociodemographic and lifestyle factors associated with MM in New Zealand.
People aged 55-70 years were invited to participate in a population-based cohort study; the Health Work and Retirement Study (HWR), in 2006. Those who accepted the invitation and completed the baseline questionnaire were followed up on a biennial basis. Data on sociodemographic factors, health and lifestyle behaviours and diagnoses of chronic disease were obtained from baseline and six waves of follow-up. Generalised Estimating Equations (GEE) adjusted for both time-constant and time-varying factors were used to model factors associated with the onset of MM.
A total of 1673 participants (with zero or one chronic condition) contributed to an overall 8616 person-years of observation. There were 590 new cases of MM over ten years of follow up; an overall incidence of 68.5 per 1000 person-years. The results of age and sex-adjusted GEE analysis showed that age, ethnicity, living alone, obesity, hypertension, and having one chronic condition at baseline, were significant predictors of MM onset. Greater education, income, physical activity, and regular alcohol consumption were protective factors. In a fully adjusted model, marital status (OR=1.18, 95%CI: 1.01-1.37, p=0.039), hypertension (OR=1.23, 95%CI: 1.02-1.48, p=0.032) and having one chronic condition at baseline (OR=2.92, 95%CI:2.33-3.67, p<0.001) remained significant.
Higher incidence of MM among Māori people, socioeconomically disadvantaged groups, those with low physical activity, and obese individuals highlights the importance of targeted prevention strategies.
Keywords: Multimorbidity; Sociodemographic; Lifestyle; Incidence; Iran
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