Linear association between number of modifiable risk factors and multiple chronic conditions: Results from the Behavioral Risk Factor Surveillance System
Preventive Medicine, Vol 105, Dec 2017, Pages 169-175, https://doi.org/10.1016/j.ypmed.2017.09.013
- We defined multiple (≥ 2) chronic conditions (MCCs) with 8 or 12 chronic conditions.
- We studied associations of MCCs with composite measures of up to 9 risk factors.
- Linear increase in MCC rates with each added risk factor, starting with one.
- All 9 risk factors are important.
- Results suggest potential for primary prevention of a wide range of conditions.
Multiple (≥ 2) chronic conditions (MCCs) are responsible for a large fraction of healthcare costs. Our aim was to examine possible associations between MCCs and composite measures of behavioral risk factors (RFs). Data were publicly available 2013 Behavioral Risk Factor Surveillance System and included 483,865 non-institutionalized US adults ages ≥ 18 years.
Chronic conditions included
Note by VitaminDWiki: All conditions are associated with low vitamin D
- chronic obstructive pulmonary disease,
- cognitive impairment,
- heart disease,
- cancer, and
- kidney disease.
- current smoking,
- sedentary lifestyle,
- inadequate fruit and vegetable consumption, and
- sleeping other than 7–8 h,
while depression, hypertension, high cholesterol, and diabetes were considered in each category.
Stata was used to study associations between 2 different MCCs and 2 composite measures of RFs in both unadjusted and adjusted analysis.
Over 96% of respondents reported ≥ 1 of the 9 RFs and 71.5% reported ≥ 1 of the chronic conditions.
For each combination there was a linear increase (with similar slopes) in MCC rate with more RFs and a statistically significant increase in adjusted odds ratios (ORs) for the MCC with each additional RF.
For the MCC based on 8 chronic conditions, ORs were
- 1.3 (95% CI 1.1, 1.6) for 1 RF,
- 2.3 (1.9, 2.7) for 2,
- 3.7 (3.1, 4.4) for 3,
- 5.7 (4.8, 6.8) for 4,
- 9.1 (7.6, 10.8) for 5,
- 14.6 (12.2, 17.4) for 6,
- 24.0 (19.7, 29.2) for 7,
- 38.1 (29.6, 48.9) for 8, and
- 100.0 (56.3, 177.8) for all 9,
each vs. zero Rfs.
Findings highlight the need for effective integrated programs to address multiple RFs and chronic conditions.
From the PDF
- MCC8: asthma, arthritis, chronic obstructive pulmonary disease, cognitive impairment, heart disease, stroke, cancer, and kidney disease.
- MCC12: adds diabetes, depression, hypertension, high cholesterol.
- COMORBIDITY AND MULTIMORBIDITY IN MEDICINE TODAY: CHALLENGES AND OPPORTUNITIES FOR BRINGING SEPARATED BRANCHES OF MEDICINE CLOSER TO EACH OTHER - 2013
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