Sex differences in the determinants and outcomes of multimorbidity clusters and their constituent conditions in the UK Biobank Study
Advances in medicine and public health have greatly increased life expectancy for women and men*. However, this has been accompanied by an increase in the number of people living with two or more long-term conditions. These may include any combination of: (i) a physical non-communicable disease of long duration (e.g. cardiovascular disease), (ii) a psychological or cognitive condition (e.g. depression or dementia), or (iii) an infectious disease of long duration (e.g. HIV). Thus, whilst people may be living longer, this does not always mean more years of life in good health.
With its large sample size and rich and varied data, the UK Biobank provides a unique opportunity to comprehensively examine how disease combinations occur in women and men. We will conduct sex-specific analyses to:
- Estimate the percentage of women and men in the UK Biobank population who are living with multiple long-term conditions
- Identify the most common combinations of long-term conditions in women and men
- Examine diverse risk factors that may be associated with the risk of developing multiple conditions
- Examine health service use and the risk of adverse health outcomes, including pain and death, among individuals living with multiple conditions.
Where appropriate, we will compare our findings to what would be expected if an individual had just one of the conditions. We will also examine whether differences exist between women and men belonging to diverse ethnic groups and socioeconomic backgrounds. The proposed project duration is 36 months.
Healthcare and related research are currently structured around single medical conditions. This limits our ability to develop a holistic understanding of how and why people develop multiple long-term conditions and the best ways to coordinate their clinical care. In addition, research has not examined in detail whether women and men are differentially affected by multiple long-term conditions. For example, it is unclear whether specific disease combinations are more or less likely to occur in one sex, or if certain risk factors are more or less strongly associated with the risk of developing multiple conditions in women compared to men. This knowledge is essential for ensuring that recommendations and interventions are developed that appropriately address the needs of women and men.
*As researchers interested in the role of sex and gender in health and disease, we acknowledge that this binary distinction of women and men does not capture the full spectrum of gender diversity.