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Prevalence and determinants of multimorbidity in the Ardabil Cohort Study, Iran
Parisa Rezanejad-Asl1, Fatemeh Gorgani2, Maryam Sharafkhah2
1Statistics and Health Economics Group, Primary HealthCare Network Management Center, Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran.
Objectives:
Multimorbidity is common in the general population, particularly among older adults, and presents a major challenge for patients and healthcare systems worldwide. We examined its prevalence and associated risk factors in Ardabil.
Methods:
We conducted a cross-sectional analysis of baseline data from 20,759 participants aged 35-70 years in the Prospective Epidemiological Research Studies in Iran cohort in Ardabil, Iran (2017-2020). Standardized questionnaires captured demographic characteristics, socioeconomic status, and lifestyle indicators. Multimorbidity was defined as two or more chronic conditions. We applied direct age and sex standardization and used multiple logistic regression to assess associations between demographic, socioeconomic, and lifestyle factors and multimorbidity.
Results:
After standardization for age and sex, multimorbidity prevalence was 31.6% (95% confidence interval [CI]: 30.99-32.25). Higher odds of multimorbidity were associated with female sex (adjusted odds ratio [ORadj] = 2.54, 95% CI: 2.23-2.77), age ≥65 years (ORadj = 12.25, 95% CI: 10.48-14.32), smoking (ORadj = 1.17, 95% CI: 1.06-1.30), alcohol use (ORadj = 1.19, 95% CI: 1.02-1.39), and obesity (ORadj = 2.80, 95% CI: 2.50-3.13). Higher physical activity was associated with lower odds of multimorbidity (ORadj = 0.73, 95% CI: 0.67-0.79).
Conclusion:
Multimorbidity was common among adults in Ardabil and was associated with older age, female sex, obesity, smoking, alcohol use, and lower physical activity. These findings indicate the importance of incorporating demographic and lifestyle factors into health policy planning and the management of chronic diseases and multimorbidity.
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