Multimorbidity Dynamics in Catalonia, 2010-2021: a Population-Based Cohort Study

Iñaki Permanyer, Centre for Demographic Studies
Jordi Guma-Lao, Centre for Demographic Studies
Sergi Trias-Llimós, Center for Demographic Studies (Barcelona)
Aïda Solé-Auró, Universitat Pompeu Fabra

Goal: Using primary care and hospital electronic health records, we describe trends in prevalence and incidence of multimorbidity across socioeconomic groups in Catalonia, a region in Spain with 8 million inhabitants. Methods: We use a random sample of 1,551,126 individuals, representing more than 22% of the Catalan population, who are followed from 2005 until 2021. We document age- and sex-specific prevalence and incidence of basic and complex multimorbidity stratifying by income groups. We use quasi-Poisson regression models to estimate the association between multimorbidity and mortality. Findings: Between 2010 and 2021, the prevalence of multimorbidity increased for both sexes and all cohorts in our analysis. Importantly, each cohort attains the same ages with higher multimorbidity prevalence than their predecessors did 10 years ago. Older generations are mostly affected by degenerative diseases, while younger ones are strongly affected by mental health problems. The median age at onset declined for both basic and complex multimorbidity. Incidence tends to vary considerably across generations (with higher levels among older generations), especially for complex multimorbidity. We observe a strong socioeconomic gradient, with lower income individuals experiencing worse outcomes in multimorbidity prevalence and incidence. Experiencing multimorbidity increases the relative risk of death.

Keywords: Health and Morbidity, Population Ageing, Longitudinal studies

See paper.