The Impact of Multimorbidity on All-Cause Mortality: A Longitudinal Study of 87,151 Thai Adults

Int J Public Health. 2023 Oct 10:68:1606137. doi: 10.3389/ijph.2023.1606137. eCollection 2023.

Abstract

Objectives: To investigate associations between multimorbidity, socio-demographic and health behaviour factors, and their interactions (multimorbidity and these factors) with all-cause mortality among Thai adults. Methods: Associations between multimorbidity (coexistence of two + chronic diseases) and mortality between 2005 and 2019 were investigated among Thai Cohort Study (TCS) participants (n = 87,151). Kaplan-Meier survival curves estimated and compared survival times. Multivariate Cox proportional hazards models examined associations between risk factors, and interactions between multimorbidity, these factors, and survival. Results: 1,958 cohort members died between 2005 and 2019. The risk of death was 43% higher for multimorbid people. In multivariate Cox proportional hazard models, multimorbidity/number of chronic conditions, age, long sleep duration, smoking and drinking were all independent factors that increased mortality risk. Women, urbanizers, university education, over 20,000-baht personal monthly income and soybean products consumption lowered risk. The interactions between multimorbidity and these variables (except for female, urbanizers and soybeans intake) also had significant (p < 0.05) impact on all-cause mortality. Conclusion: The results emphasise the importance of healthy lifestyle and reduced intake of alcohol and tobacco, in reducing premature mortality, especially when suffering from multimorbidity.

Keywords: Thai Cohort Study; all-cause mortality; lifestyle behaviour; multimorbidity; socio-demographics status.

MeSH terms

  • Adult
  • Chronic Disease* / epidemiology
  • Chronic Disease* / mortality
  • Cohort Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Multimorbidity*
  • Risk Factors
  • Southeast Asian People* / statistics & numerical data
  • Thailand / epidemiology