Impact of Socioeconomic Inequalities in Transition Between Health, Multimorbidity and Death Amongst Older People

University College London (UCL) logo

University College London (UCL)

Status

Unknown

Conditions

Multimorbidity

Treatments

Other: This is not an intervention study

Study type

Observational

Funder types

Other

Identifiers

NCT02609516
14_179

Details and patient eligibility

About

Life expectancy at age 65 in the most deprived fifth of the English population was about 4 years shorter than of the most affluent fifth in 2010. The inverse gradient between mortality and social position is well established. But how disease patterns and multimorbidity (having two or more long term conditions at the same time) impact on differential mortality rates is inconclusive: is it because disadvantaged groups acquire more or more lethal combinations of, diseases over their life course; or, simply, become ill at ages younger than more affluent groups?

Full description

The association between social inequality and cause-specific mortality and single disease morbidity has been studied extensively. However, it remains unclear whether having two or more chronic diseases concurrently (or 'multimorbidity') plays a role in contributing to the inequalities gap in survival. This is particularly relevant given an ageing population and the trend of a widening in the life expectancy gap across several European countries. Multimorbidity incidence increases rapidly with age. Estimates of the prevalence of multimorbidity in older people range from 55% to 98%, mainly due to the selection of diseases included, population coverage (hospital, community) and data source (self-reported surveys or clinical records). However, across all studies there is a clear and consistent pattern of higher prevalence rates at older ages, with multimorbidity. Many aspects of the patient health trajectory remain under-explored. Patient case-mixes are likely to vary across socioeconomic groups, alongside a host of prognostic factors, including the clustering of multiple risk factors, age of onset, and disease presentation, progression and management in the presence of multiple health conditions.

Enrollment

1,300,000 estimated patients

Sex

All

Ages

45+ years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Registered with a participating practice that has agreed to data linkage
  • Registered with an 'up to standard' participating general practice for at least 1 year
  • Aged 45 and over on Jan 1st 2001 or who turn 45 between 1st Jan 2001 and 25th March 2010, irrespective of initial health status.

Exclusion criteria

  • Patients with a record unlinked to deprivation due to missing or incomplete postcode of residence.

Trial design

1,300,000 participants in 2 patient groups

Healthy
Description:
Patients without any of the pre-specified chronic diseases
Treatment:
Other: This is not an intervention study
Multimorbid
Description:
Patients having any two or more of the pre-specified chronic diseases
Treatment:
Other: This is not an intervention study

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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