Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study
Background Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. Methods We identified patterns of longitudinal multimorbidity accumulation using 30 years o...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-03-01
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| Series: | Journal of Multimorbidity and Comorbidity |
| Online Access: | https://doi.org/10.1177/26335565241242277 |
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| author | C Barrett Bowling Richard A Faldowski Richard Sloane Carl Pieper Tyson H Brown Erin E Dooley Brett T Burrows Norrina B Allen Kelley Pettee Gabriel Cora E Lewis |
| author_facet | C Barrett Bowling Richard A Faldowski Richard Sloane Carl Pieper Tyson H Brown Erin E Dooley Brett T Burrows Norrina B Allen Kelley Pettee Gabriel Cora E Lewis |
| author_sort | C Barrett Bowling |
| collection | DOAJ |
| description | Background Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. Methods We identified patterns of longitudinal multimorbidity accumulation using 30 years of data from in-person exams, annual follow-ups, and adjudicated end-points among 4,945 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Chronic conditions included arthritis, asthma, atrial fibrillation, cancer, end stage renal disease, chronic obstructive pulmonary disease, coronary heart disease, diabetes, heart failure, hyperlipidemia, hypertension, and stroke. Trajectory patterns were identified using latent class growth curve models. Results Mean age (SD) at baseline (1985-6) was 24.9 (3.6), 55% were female, and 51% were Black. The median follow-up was 30 years (interquartile range 25-30). We identified six trajectory classes characterized by when conditions began to accumulate and the rapidity of accumulation: (1) early-fifties, slow, (2) mid-forties, fast, (3) mid-thirties, fast, (4) late-twenties, slow, (5) mid-twenties, slow, and (6) mid-twenties, fast. Compared with participants in the early-fifties, slow trajectory class, participants in mid-twenties, fast were more likely to be female, Black, and currently smoking and had a higher baseline mean waist circumference (83.6 vs. 75.6 cm) and BMI (27.0 vs. 23.4 kg/m 2 ) and lower baseline physical activity (414.1 vs. 442.4 exercise units). Conclusions A life course approach that recognizes the heterogeneity in patterns of accumulation of chronic conditions from early adulthood into middle age could be helpful for identifying high risk subgroups and developing approaches to delay multimorbidity progression. |
| format | Article |
| id | doaj-art-ae85ed3753df48d89443bdc7df72619e |
| institution | OA Journals |
| issn | 2633-5565 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Multimorbidity and Comorbidity |
| spelling | doaj-art-ae85ed3753df48d89443bdc7df72619e2025-08-20T02:12:15ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652024-03-011410.1177/26335565241242277Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort studyC Barrett BowlingRichard A FaldowskiRichard SloaneCarl PieperTyson H BrownErin E DooleyBrett T BurrowsNorrina B AllenKelley Pettee GabrielCora E LewisBackground Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. Methods We identified patterns of longitudinal multimorbidity accumulation using 30 years of data from in-person exams, annual follow-ups, and adjudicated end-points among 4,945 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Chronic conditions included arthritis, asthma, atrial fibrillation, cancer, end stage renal disease, chronic obstructive pulmonary disease, coronary heart disease, diabetes, heart failure, hyperlipidemia, hypertension, and stroke. Trajectory patterns were identified using latent class growth curve models. Results Mean age (SD) at baseline (1985-6) was 24.9 (3.6), 55% were female, and 51% were Black. The median follow-up was 30 years (interquartile range 25-30). We identified six trajectory classes characterized by when conditions began to accumulate and the rapidity of accumulation: (1) early-fifties, slow, (2) mid-forties, fast, (3) mid-thirties, fast, (4) late-twenties, slow, (5) mid-twenties, slow, and (6) mid-twenties, fast. Compared with participants in the early-fifties, slow trajectory class, participants in mid-twenties, fast were more likely to be female, Black, and currently smoking and had a higher baseline mean waist circumference (83.6 vs. 75.6 cm) and BMI (27.0 vs. 23.4 kg/m 2 ) and lower baseline physical activity (414.1 vs. 442.4 exercise units). Conclusions A life course approach that recognizes the heterogeneity in patterns of accumulation of chronic conditions from early adulthood into middle age could be helpful for identifying high risk subgroups and developing approaches to delay multimorbidity progression.https://doi.org/10.1177/26335565241242277 |
| spellingShingle | C Barrett Bowling Richard A Faldowski Richard Sloane Carl Pieper Tyson H Brown Erin E Dooley Brett T Burrows Norrina B Allen Kelley Pettee Gabriel Cora E Lewis Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study Journal of Multimorbidity and Comorbidity |
| title | Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study |
| title_full | Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study |
| title_fullStr | Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study |
| title_full_unstemmed | Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study |
| title_short | Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study |
| title_sort | multimorbidity trajectories in early adulthood and middle age findings from the cardia prospective cohort study |
| url | https://doi.org/10.1177/26335565241242277 |
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