User:Tamsyn Blake/sandbox

Disease Prevalence
''Multimorbidity is common in older adults, estimated to affect over half of those aged 65 and over. This increased prevalence has been explained by older adults' "longer exposure and increased vulnerability to risk factors for chronic health problems". The prevalence of multimorbidity has been increasing in recent decades. The high prevalence of multimorbidity has led to some describing it as "The most common chronic condition". Multimorbidity is also more common among people from lower Socioeconomic statuses. Multimorbidity is a significant issue in low‐ and middle‐income countries, though prevalence is not as high as in high income countries.''

Impact
Multimorbidity is associated with reduced quality of life and increased risk of death.

''People with multimorbidity face many challenges because of the way health systems are organised. Most health systems are designed to cater for people with a single chronic condition. Some of the difficulties experienced by people with multimorbidity include: poor coordination of medical care, managing multiple medications, high costs associated with treatment, increases in their time spent managing illness, difficulty managing multiple illness management regimes, and aggravation of one condition by symptoms or treatment of another.'' Physical and mental health conditions can adversely impact the other through a number of pathways, and have significant impact on health and wellbeing. For people with severe mental illness, addressing the underlying risk factors for physical health problems is critical to good outcomes.

''Due to the higher prevalence of multimorbidity (55 - 98%), a new concept of "complex multimorbidity (CMM)" has been proposed. CMM differs from the definition of conventional multimorbidity in that CMM is defined by the number of body systems affected by the diseases rather than the number of diseases. CMM is associated is mortality and long-term care needs in older adults.''

Risk Factors
A range of biological, psychological, behavioural, socioeconomic and environmental factors affect the likelihood of having multiple long-term conditions. How biological, psychological, behavioural, socioeconomic and environmental risk factors interact to trigger multiple conditions is complex and still not fully understood.

Prevention
There are well-evidenced prevention strategies for many of the component diseases of multiple condition clusters. For example:


 * tobacco cessation - to prevent cardiovascular, respiratory and several neoplastic diseases
 * a reduction in blood pressure - to prevent coronary disease, ischaemic stroke, cerebral haemorrhage, congestive heart failure and chronic kidney disease, and
 * LDL-cholesterol lowering - to prevent coronary heart disease and ischaemic stroke.

An increased understanding of which conditions most commonly cluster, along with  their underlying risk factors, would help prioritise strategies for early diagnosis, screening and prevention.