Show simple item record

dc.rights.licenseAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)
dc.contributor.authorTan, Michelle M C
dc.contributor.authorPrina, A Matthew
dc.contributor.authorMuniz-Terrera, Graciela
dc.contributor.authorMohan, Devi
dc.contributor.authorIsmail, Roshidi
dc.contributor.authorAssefa, Esubalew
dc.contributor.authorKeinert, Ana Á M
dc.contributor.authorKassim, Zaid
dc.contributor.authorAllotey, Pascale
dc.contributor.authorReidpath, Daniel
dc.contributor.authorSu, Tin Tin
dc.identifierpublisher-id: bmjopen-2022-068172
dc.identifierdoi: 10.1136/bmjopen-2022-068172
dc.identifier.citationTan, M.M.C., Prina, A.M., Muniz-Terrera, G., Mohan, D., Ismail, R., Assefa, E., Keinert, A.Á.M., Kassim, Z., Allotey, P., Reidpath, D. and Su, T.T. (2022) ‘Prevalence of and factors associated with multimorbidity among 18 101 adults in the South East Asia Community Observatory Health and Demographic Surveillance System in Malaysia: a population-based, cross-sectional study of the MUTUAL consortium’, BMJ Open, 12(12), p. e068172. Available at:
dc.descriptionFrom BMJ via Jisc Publications Router
dc.descriptionHistory: received 2022-09-10, ppub 2022-12, accepted 2022-12-05, epub 2022-12-23
dc.descriptionPeer reviewed: True
dc.descriptionPublication status: Published
dc.descriptionFunder: King’s College London; FundRef:; Grant(s): Medical Research Council grant / MR/T037423/1
dc.descriptionDaniel Reidpath - ORCID: 0000-0002-8796-0420
dc.description.abstractObjectives: To assess the prevalence and factors associated with multimorbidity in a community-dwelling general adult population on a large Health and Demographic Surveillance System (HDSS) scale. Design: Population-based cross-sectional study. Setting: South East Asia Community Observatory HDSS site in Malaysia. Participants: Of 45 246 participants recruited from 13 431 households, 18 101 eligible adults aged 18–97 years (mean age 47 years, 55.6% female) were included. Main outcome measures: The main outcome was prevalence of multimorbidity. Multimorbidity was defined as the coexistence of two or more chronic conditions per individual. A total of 13 chronic diseases were selected and were further classified into 11 medical conditions to account for multimorbidity. The conditions were heart disease, stroke, diabetes mellitus, hypertension, chronic kidney disease, musculoskeletal disorder, obesity, asthma, vision problem, hearing problem and physical mobility problem. Risk factors for multimorbidity were also analysed. Results: Of the study cohort, 28.5% people lived with multimorbidity. The individual prevalence of the chronic conditions ranged from 1.0% to 24.7%, with musculoskeletal disorder (24.7%), obesity (20.7%) and hypertension (18.4%) as the most prevalent chronic conditions. The number of chronic conditions increased linearly with age (p<0.001). In the logistic regression model, multimorbidity is associated with female sex (adjusted OR 1.28, 95% CI 1.17 to 1.40, p<0.001), education levels (primary education compared with no education: adjusted OR 0.63, 95% CI 0.53 to 0.74; secondary education: adjusted OR 0.60, 95% CI 0.51 to 0.70; tertiary education: adjusted OR 0.65, 95% CI 0.54 to 0.80; p<0.001) and employment status (working adults compared with retirees: adjusted OR 0.70, 95% CI 0.60 to 0.82, p<0.001), in addition to age (adjusted OR 1.05, 95% CI 1.05 to 1.05, p<0.001). Conclusions: The current single-disease services in primary and secondary care should be accompanied by strategies to address complexities associated with multimorbidity, taking into account the factors associated with multimorbidity identified. Future research is needed to identify the most commonly occurring clusters of chronic diseases and their risk factors to develop more efficient and effective multimorbidity prevention and treatment strategies.
dc.publisherBMJ Publishing Group
dc.rightsLicence for this article starting on 2022-12-23:
dc.rightsEmbargo: ends 2022-12-23
dc.rights© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
dc.sourceeissn: 2044-6055
dc.subjectHealth services administration & management
dc.subjectPublic health
dc.titlePrevalence of and factors associated with multimorbidity among 18 101 adults in the South East Asia Community Observatory Health and Demographic Surveillance System in Malaysia: a population-based, cross-sectional study of the MUTUAL consortium
qmu.authorReidpath, Daniel
qmu.centreInstitute for Global Health and Developmenten

Files in this item


This item appears in the following Collection(s)

Show simple item record

Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Except where otherwise noted, this item's license is described as Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)