Multimorbidity trends in Catalonia, 2010-21: a population-based cohort study

With rising longevity, multimorbidity is an increasingly important challenge for healthcare systems. We describe trends in the prevalence and incidence of multimorbidity across socioeconomic groups in Catalonia.

We use a random sample of 1 551 126 individuals (22% of the Catalan population, for whom we have the complete primary care health records) and follow them from 2010 until 2021. We document the age- and sex-specific prevalence and incidence of multimorbidity stratifying by income groups and birth cohorts. Logistic regression models are used to estimate the association between multimorbidity and mortality.

Between 2010 and 2021, the prevalence of multimorbidity, higher among women, has increased for both sexes and all cohorts in our analysis. Importantly, each cohort attains the same ages, with higher multimorbidity prevalence than their predecessors had 10 years ago. Older generations are mostly affected by degenerative diseases, while younger age groups are more affected by mental health problems. Incidence tends to be higher among the older cohorts across all adult ages. We observe a strong socioeconomic gradient, with lower-income individuals experiencing worse multimorbidity prevalence and incidence. Such a gradient is persistent and becomes more pronounced at the end of the study period. Across all age groups, individuals experiencing multimorbidity have a higher risk of dying than those who do not.

The documented increases in multimorbidity alongside its socioeconomic gradients suggest that preventive strategies are urgently needed to defer or prevent its onset and slow its progression-especially among younger generations.