Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study
Objective: To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru. Methods: Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. S...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-11-01
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| Series: | Journal of Comorbidity |
| Online Access: | https://doi.org/10.1177/2235042X19875297 |
| _version_ | 1818527874892693504 |
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| author | J Jaime Miranda Antonio Bernabe-Ortiz Robert H Gilman Liam Smeeth German Malaga Robert A Wise William Checkley |
| author_facet | J Jaime Miranda Antonio Bernabe-Ortiz Robert H Gilman Liam Smeeth German Malaga Robert A Wise William Checkley |
| author_sort | J Jaime Miranda |
| collection | DOAJ |
| description | Objective: To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru. Methods: Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. Six of these conditions (alcohol disorder, asthma, chronic obstructive pulmonary disease, depression, diabetes, and hypertension) were cataloged as objectively ascertained chronic conditions and paired in dyads to explore clusters of multimorbidity. Results: We analyzed data from 2890 adults, mean age 55.2 years, 49% males. Overall, 19.1% of participants had multimorbidity, ranging from 14.7% in semi-urban Tumbes to 22.8% in Lima. The dyads with the highest coexistence (approximately 20%) were observed in hypertension and diabetes in Tumbes, whereas the dyads with lowest coexistence (approximately 1%) were those involving asthma in all study sites. In terms of clusters, Tumbes showed a predominance of hypertension and diabetes, urban and rural Puno a predominance of depression and alcohol disorders, and Lima a higher degree of coexistence of all of the six conditions than in the other clusters. Conclusion: Multimorbidity is common and the pattern of clusters is highly heterogeneous. The conditions to prioritize will vary in each setting. |
| first_indexed | 2024-12-11T06:42:08Z |
| format | Article |
| id | doaj.art-155b1166acf3447a9592cf0f9a01978b |
| institution | Directory Open Access Journal |
| issn | 2235-042X |
| language | English |
| last_indexed | 2024-12-11T06:42:08Z |
| publishDate | 2019-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Comorbidity |
| spelling | doaj.art-155b1166acf3447a9592cf0f9a01978b2022-12-22T01:17:11ZengSAGE PublishingJournal of Comorbidity2235-042X2019-11-01910.1177/2235042X19875297Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort StudyJ Jaime Miranda0Antonio Bernabe-Ortiz1Robert H Gilman2Liam Smeeth3German Malaga4Robert A Wise5William Checkley6 Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Peru Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USAObjective: To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru. Methods: Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. Six of these conditions (alcohol disorder, asthma, chronic obstructive pulmonary disease, depression, diabetes, and hypertension) were cataloged as objectively ascertained chronic conditions and paired in dyads to explore clusters of multimorbidity. Results: We analyzed data from 2890 adults, mean age 55.2 years, 49% males. Overall, 19.1% of participants had multimorbidity, ranging from 14.7% in semi-urban Tumbes to 22.8% in Lima. The dyads with the highest coexistence (approximately 20%) were observed in hypertension and diabetes in Tumbes, whereas the dyads with lowest coexistence (approximately 1%) were those involving asthma in all study sites. In terms of clusters, Tumbes showed a predominance of hypertension and diabetes, urban and rural Puno a predominance of depression and alcohol disorders, and Lima a higher degree of coexistence of all of the six conditions than in the other clusters. Conclusion: Multimorbidity is common and the pattern of clusters is highly heterogeneous. The conditions to prioritize will vary in each setting.https://doi.org/10.1177/2235042X19875297 |
| spellingShingle | J Jaime Miranda Antonio Bernabe-Ortiz Robert H Gilman Liam Smeeth German Malaga Robert A Wise William Checkley Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study Journal of Comorbidity |
| title | Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study |
| title_full | Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study |
| title_fullStr | Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study |
| title_full_unstemmed | Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study |
| title_short | Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study |
| title_sort | multimorbidity at sea level and high altitude urban and rural settings the cronicas cohort study |
| url | https://doi.org/10.1177/2235042X19875297 |
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