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Multimorbidity and ...
Multimorbidity and mortality in an older, rural black South African population cohort with high prevalence of HIV findings from the HAALSI Study
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- Wade, Alisha N (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa
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- Payne, Collin F (författare)
- School of Demography, Research School of Social Sciences, Australian National University, ACT, Canberra, Australia
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- Berkman, Lisa (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa; Harvard Centre for Population and Development Studies, Harvard University, T H Chan School of Public Health, MA, Cambridge, United States
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- Chang, Angela (författare)
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark
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- Gómez-Olivé, F Xavier (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa
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- Kabudula, Chodziwadziwa (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa
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- Kahn, Kathleen (författare)
- Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden;MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa
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- Salomon, Joshua A (författare)
- Department of Health Policy, Stanford University, School of Medicine, CA, Palo Alto, United States
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- Tollman, Stephen M. (författare)
- Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa
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- Witham, Miles (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa; Age Research Group, Nihr Newcastle Biomedical Research Centre, Translational Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle Upon Tyne Hospitals Nhs Foundation Trust, Newcastle upon Tyne, United Kingdom
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- Davies, Justine (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Faculty of Health Sciences, Gauteng, Johannesburg, South Africa; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom; Centre for Global Surgery, Department of Global Health, Stellenbosch University, Western Cape, Stellenbosch, South Africa
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(creator_code:org_t)
- 2021-09-15
- 2021
- Engelska.
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:9
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://bmjopen.bmj....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Objectives: Multimorbidity is associated with mortality in high-income countries. Our objective was to investigate the relationship between multimorbidity (≥2 of the following chronic medical conditions: hypertension, diabetes, dyslipidaemia, anaemia, HIV, angina, depression, post-traumatic stress disorder, alcohol dependence) and all-cause mortality in an older, rural black South African population. We further investigated the relationship between HIV multimorbidity (HIV as part of the multimorbidity cluster) and mortality, while testing for the effect of frailty in all models.Design: Population cohort study.Setting: Agincourt subdistrict of Mpumalanga province, South Africa.Participants: 4455 individuals (54.7% female), aged ≥40 years (median age 61 years, IQR 52-71) and resident in the study area.Primary and secondary outcome measures: The primary outcome measure was time to death and the secondary outcome measure was likelihood of death within 2 years of the initial study visit. Mortality was determined during annual population surveillance updates.Results: 3157 individuals (70.9%) had multimorbidity; 29% of these had HIV. In models adjusted for age and sociodemographic factors, multimorbidity was associated with greater risk of death (women: HR 1.72; 95% CI: 1.18 to 2.50; men: HR 1.46; 95% CI: 1.09 to 1.95) and greater odds of dying within 2 years (women: OR 2.34; 95% CI: 1.32 to 4.16; men: OR 1.51; 95% CI: 1.02 to 2.24). HIV multimorbidity was associated with increased risk of death compared with non-HIV multimorbidity in men (HR 1.93; 95% CI: 1.05 to 3.54), but was not statistically significant in women (HR 1.85; 95% CI: 0.85 to 4.04); when detectable, HIV viral loads were higher in men (p=0.021). Further adjustment for frailty slightly attenuated the associations between multimorbidity and mortality risk (women: HR 1.55; 95% CI: 1.06 to 2.26; men: HR 1.36; 95% CI: 1.01 to 1.82), but slightly increased associations between HIV multimorbidity and mortality risk.Conclusions: Multimorbidity is associated with mortality in this older black South African population. Health systems which currently focus on HIV should be reorganised to optimise identification and management of other prevalent chronic diseases.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Gerontologi, medicinsk/hälsovetenskaplig inriktning (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Gerontology, specialising in Medical and Health Sciences (hsv//eng)
Nyckelord
- epidemiology
- geriatric medicine
- public health
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Wade, Alisha N
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Payne, Collin F
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Berkman, Lisa
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Chang, Angela
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Gómez-Olivé, F X ...
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Kabudula, Chodzi ...
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Kahn, Kathleen
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Salomon, Joshua ...
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Tollman, Stephen ...
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Witham, Miles
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Davies, Justine
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