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Type: Journal article
Title: Individual diseases or clustering of health conditions? Association between multiple chronic diseases and health-related quality of life in adults
Author: González-Chica, D.
Hill, C.
Gill, T.
Hay, P.
Haag, D.
Stocks, N.
Citation: Health and Quality of Life Outcomes, 2017; 15(1):244-1-244-9
Publisher: BioMed Central
Issue Date: 2017
ISSN: 1477-7525
Statement of
David Alejandro González-Chica, Catherine L. Hill, Tiffany K. Gill, Phillipa Hay, Dandara Haag and Nigel Stocks
Abstract: Background: Chronic diseases are highly prevalent and cluster in individuals (multimorbidity). This study investigated the association between multimorbidity and Health-Related Quality of Life (HRQoL), assessing the combination of chronic diseases highly correlated with this outcome. Methods: We conducted a household survey in 2015 in a random sample of 2912 South Australian adults (48.9 ± 18.1 years; 50.9% females), obtaining information on sociodemographics, lifestyle, and 17 chronic conditions clustered in four different groups (metabolic, cardiovascular, gastrointestinal, and musculoskeletal). Information on physical (PCS) and mental components scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Multivariable linear regression models considering individual diseases (mutually adjusted) and clusters within- and between-groups were used to test the associations. Results: Only 41% of the sample was negative for all the investigated diseases. The most prevalent conditions were osteoarthritis, obesity and hypertension, which affected one in every four individuals. PCS was markedly lower among those reporting stroke, heart failure, and osteoarthritis, but they were not associated with MCS. Direct-trend relationships were observed between the number of chronic conditions (clusters within- and between-groups) and PCS, but not with MCS. The strongest association with PCS was for musculoskeletal conditions (difference between those affected by 2+ conditions and those free of these conditions -6.7 95%CI -8.5;-5.4), and lower PCS were observed in any combination of clusters between-group including musculoskeletal diseases. Conclusion: In the context of multimorbidity, musculoskeletal diseases are a key determinant group of PCS, amplifying the association of other chronic conditions on physical but not on mental health.
Keywords: Quality of life; multimorbidity; multiple chronic conditions; chronic disease; epidemiologic methods
Rights: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
RMID: 0030079676
DOI: 10.1186/s12955-017-0806-6
Appears in Collections:Medicine publications

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