Prevalence of multimorbidity and its correlates among older adults in Eastern Nepal

Siva Balakrishnan; Isha Karmacharya; Saruna Ghimire; Sabuj Kanti Mistry; Devendra Raj Singh; Om Prakash Yadav; Nachiket Gudi; Lal Bahadur Rawal; Uday Narayan Yadav

doi:10.1186/s12877-022-03115-2

Prevalence of multimorbidity and its correlates among older adults in Eastern Nepal

BMC Geriatr. 2022 May 16;22(1):425. doi: 10.1186/s12877-022-03115-2.

Authors

Affiliations

¹ School of Public Health, University of Nevada Reno, Reno, NV, USA.
² Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA.
³ Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
⁴ School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, UK.
⁵ Ministry of Health and Population, Kathmandu, Nepal.
⁶ Public Health Evidence South Asia (PHESA), Department of Health Information, Prasanna School of Public Health, Manipal, Karnataka, India.
⁷ School of Health Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney Campus, Sydney, Australia.
⁸ Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia. unyadav1@gmail.com.
⁹ National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia. unyadav1@gmail.com.
¹⁰ Centre for Research Policy and Implementation (CRPIN), Biratnagar, Nepal. unyadav1@gmail.com.

Abstract

Background: The number of people with multimorbidity is surging around the world. Although multimorbidity has been introduced in policy and practice in developed countries, developing countries like Nepal have not considered it as a matter of public health urgency due to the lack of enough epidemiological data. Multimorbidity profoundly affects older adults' wellbeing; therefore, it is crucial to estimate its prevalence and determinants. This study aimed to estimate the prevalence of multimorbidity among older adults in Eastern Nepal and identify its correlates.

Methodology: A community-based cross-sectional survey was conducted in three districts of Eastern Nepal. Data were collected between July and September 2020, among 847 Nepali older adults, aged 60 and older, where study participants were recruited through a multi-stage cluster sampling technique. Semi-structured interviews were conducted at the community settings to collect data. Logistic regression assessed correlates of multimorbidity. SAS 9.4 was used to run all statistical tests and analyses.

Results: More than half (66.5%) of the participants had at least one of the five non-communicable chronic conditions; hypertension (31.6%), osteoarthritis (28.6%), chronic respiratory disease (18.0%), diabetes (13.5%), and heart disease (5.3%). The prevalence of multimorbidity was 22.8%. In the adjusted model, increased age (for 70-79 years, OR: 3.11, 95% CI: 1.87-5.18; for 80 + years, OR: 4.19, 95% CI: 2.32-7.57), those without a partner (OR: 1.52, 95% CI: 1.00-2.30), residing in urban areas (OR: 1.71, 95% CI: 1.16-2.51), and distant from health center (OR: 1.66, 95% CI: 1.04-2.64) were significantly associated with multimorbidity.

Conclusions: This study found one in five study participants had multimorbidity. The findings will assist policymakers and stakeholders in understanding the burden of multimorbidity among the older population and identifying the groups in most need of health promotion intervention. Future interventions may include developing horizontal multimorbid approaches and multisectoral strategies specifically tailored to meet the needs of those populations.

Keywords: Chronic diseases; Multimorbidity; NCDs; Nepal; Older adults.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Chronic Disease
Cross-Sectional Studies
Humans
Middle Aged
Multimorbidity*
Nepal / epidemiology
Prevalence