A longitudinal Analysis of the Association between Socioeconomic Position and Multimorbidity in the European Prospective Investigation into Cancer and Nutrition Study.

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Tác giả: Alem Abraha, Christian Skødt Antoniussen, Catalina Bonet Bonet, Federica Buscema, Alberto Catalano, Sandra Colorado-Yohar, Reynalda Cordova, Christina C Dahm, Marcela Guevara Eslava, Pietro Ferrari, Heinz Freisling, Sara Grioni, Marc J Gunter, Rudolf Kaaks, Verena Katzke, Luca Manfredi, Giovanna Masala, Lorenzo Milani, Olatz Mokoroa, Anja Olsen, Salvatore Panico, Chiara Raganato, Fulvio Ricceri, Carlotta Sacerdote, Maria-Jose Sánchez, Matthias B Schulze, Barbara Sodano, Sandar Tin Tin, Anne Tjønneland, Rosario Tumino, Ilonca Vaartjes, Roel Vermeulen, Monique Verschuren

Ngôn ngữ: eng

Ký hiệu phân loại: 271.6 *Passionists and Redemptorists

Thông tin xuất bản: United States : Aging and disease , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 199235

The association between socioeconomic position (SEP) and non-communicable diseases (NCDs) is well established, but its role in driving multimorbidity remains unclear. Multimorbidity, defined as the co-occurrence of more than one chronic condition, is linked to higher mortality and reduced quality of life. This study investigates the association between SEP and multimorbidity using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Incident cases of cancer, type 2 diabetes (T2D), and cardiovascular diseases (CVDs) were analysed alongside lifestyle factors such as smoking status, alcohol intake, body mass index (BMI), physical activity and diet. Multimorbidity was defined as the presence of at least two of the studied NCDs. SEP was assessed using the Relative Index of Inequality (RII) and categorized into high, medium, and low SEP. The cohort included 277 302 participants (60.7% women) from seven countries, enrolled between 1992-2000 and followed until the first diagnosis, end of follow-up (31/12/2007), or death. For transitions to multimorbidity, follow-up extended from the first diagnosis to the second diagnosis, end of follow-up, or death. Multistate models were used to examine the nine possible transitions to first diagnoses and multimorbidity combinations. Lifestyle factors were risk factors for all the transitions, except alcohol intake. In the main model, not stratified by sex, low SEP was associated with higher risks of progressing from cancer to CVD (Hazard Ratio (HR): 1.23, CI: 1.02-1.50), CVD to T2D (HR: 1.35, CI: 1.07-1.71), and cancer to T2D (HR: 1.37, CI: 1.10-1.69). These findings highlight the persistent influence of social inequalities on the risk of multimorbidity, even in individuals with an existing chronic condition.
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