The influence of socioeconomic deprivation on multimorbidity at different ages: a cross-sectional study

Background: Multimorbidity occurs at a younger age in individuals in areas of high socioeconomic deprivation but little is known about the 'typology' of multimorbidity in different age groups and its association with socioeconomic status.

Aim: To characterise multimorbidity type and most common conditions in a large nationally representative primary care dataset in terms of age and deprivation.

Design and setting: Cross-sectional analysis of 1 272 685 adults in Scotland.

Method: Multimorbidity type of participants (physical-only, mental-only, mixed physical, and mental) and most common conditions were analysed according to age and deprivation.

Results: Multimorbidity increased with age, ranging from 8.1% in those aged 25-34 to 76.1% for those aged ≥75 years. Physical-only (56% of all multimorbidity) was the most common type of multimorbidity in those aged ≥55 years, and did not vary substantially with deprivation. Mental-only was uncommon (4% of all multimorbidity), whereas mixed physical and mental (40% of all multimorbidity) was the most common type of multimorbidity in those aged <55 years and was two- to threefold more common in the most deprived compared with the least deprived in most age groups. Ten conditions (seven physical and three mental) accounted for the top five most common conditions in people with multimorbidity in all age groups. Depression and pain featured in the top five conditions across all age groups. Deprivation was associated with a higher prevalence of depression, drugs misuse, anxiety, dyspepsia, pain, coronary heart disease, and diabetes in multimorbid patients at different ages.

Conclusion: Mixed physical and mental multimorbidity is common across the life-span and is exacerbated by deprivation from early adulthood onwards.