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Publication Detail
Prevalence and early-life determinants of mid-life multimorbidity: evidence from the 1970 British birth cohort
  • Publication Type:
    Journal article
  • Authors:
    Gondek D, Bann D, Brown M, Hamer M, Sullivan A, Ploubidis GB
  • Publication date:
    28/07/2021
  • Journal:
    BMC Public Health
  • Volume:
    21
  • Issue:
    1
  • Article number:
    1319
  • Status:
    Published
  • Country:
    England
  • Print ISSN:
    1471-2458
  • PII:
    10.1186/s12889-021-11291-w
  • Language:
    English
  • Keywords:
    Birth cohorts, Determinants of health, Mid-life, Risk factors, UK
  • Notes:
    This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Abstract
BACKGROUND: We sought to: [1] estimate the prevalence of multimorbidity at age 46-48 in the 1970 British Cohort Study-a nationally representative sample in mid-life; and [2] examine the association between early-life characteristics and mid-life multimorbidity. METHOD: A prospective longitudinal birth cohort of a community-based sample from the 1970 British Cohort Study (BCS70). Participants included all surviving children born in mainland Britain in a single week in April 1970; the analytical sample included those with valid data at age 46-48 (n = 7951; 2016-2018). The main outcome was multimorbidity, which was operationalised as a binary indicator of two or more long-term health conditions where at least one of these conditions was of physical health. It also included symptom complexes (e.g., chronic pain), sensory impairments, and alcohol problems. RESULTS: Prevalence of mid-life multimorbidity was 33.8% at age 46-48. Those with fathers from unskilled social occupational class (vs professional) at birth had 43% higher risk of mid-life multimorbidity (risk ratio = 1.43, 95% confidence interval 1.15 to 1.77). After accounting for potential child and family confounding, an additional kilogram of birthweight was associated with 10% reduced risk of multimorbidity (risk ratio = 0.90, 95% confidence interval 0.84 to 0.96); a decrease of one body mass index point at age 10 was associated with 3% lower risk (risk ratio = 1.03, 95% confidence interval 1.01 to 1.05); one standard deviation higher cognitive ability score at age 10 corresponded to 4% lower risk (risk ratio = 0.96, 95% confidence interval 0.91 to 1.00); an increase of one internalising problem at age 16 was equated with 4% higher risk (risk ratio = 1.04, 95% confidence interval 1.00 to 1.08) and of one externalising problem at age 16 with 6% higher risk (risk ratio = 1.06, 1.03 to 1.09). CONCLUSION: Prevalence of multimorbidity was high in mid-life (33.8% at age 46-48) in Britain. Potentially modifiable early-life exposures, including early-life social circumstances, cognitive, physical and emotional development, were associated with elevated risk of mid-life multimorbidity.
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