ArticleBMJ open2019
Sex-specific intergenerational trends in morbidity burden and multimorbidity status in Hong Kong community: an age-period-cohort analysis of repeated population surveys.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Community prevalence and dyad disease pattern of multimorbidity in China and India: a systematic review.BMJ global health · 2022Pooled it
- Age-period-cohort analysis of multimorbidity prevalence among Chinese older adults: from 2002 to 2022.GeroScience · 2026Article
- Disease accumulation across birth cohorts in South Korea.The journals of gerontology. Series B, Psychological sciences and social sciences · 2025Article
- Multimorbidity incidence following hospitalization for SARS-CoV-1 infection or influenza over two decades: a territory-wide retrospective cohort study.NPJ primary care respiratory medicine · 2025Article
- The diabetes mellitus comorbidity index in European Union member states based on the 2019 European Health Interview Survey.Scientific reports · 2025Article
- Age-specific Multimorbidity Patterns and Burden on All-Cause Mortality and Public Direct Medical Expenditure: A Retrospective Cohort Study.Journal of epidemiology and global health · 2024Observational
- Insights from Chilean NCDs Hospitalization Data during COVID-19.Medicina (Kaunas, Lithuania) · 2024Article
- Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis.EClinicalMedicine · 2023Article
- Long-Term Blood Pressure Variability and Major Adverse Cardiovascular and Cerebrovascular Events After Intracerebral Hemorrhage.Journal of the American Heart Association · 2022Article
- Trends of multimorbidity in 15 European countries: a population-based study in community-dwelling adults aged 50 and over.BMC public health · 2021Article
- Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults.Frontiers in medicine · 2021Article
- Multimorbidity among Two Million Adults in China.International journal of environmental research and public health · 2020Article
- Age-Period-Cohort Analysis on the Time Trend of Hepatitis B Incidence in Four Prefectures of Southern Xinjiang, China from 2005 to 2017.International journal of environmental research and public health · 2019Article
- Educational inequality in physician-diagnosed hypertension widened and persisted among women from 1999 to 2014 in Hong Kong.Scientific reports · 2019Article
- Psychometric Validation of the Cantonese Version of the Patient-Centered Primary Care Instrument for Multimorbid Patients in Hong Kong.Journal of primary care & community healthArticle
- The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review.Journal of multimorbidity and comorbidityReview
- Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies.Journal of comorbidityReview
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7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPrevalence of multimorbidity has been increasing worldwide. While population ageing undoubtedly contributes, secular trends have seldom been decomposed into age, period and cohort effects to investigate intergenerational differences. This study examines the birth cohort effect on morbidity burden and multimorbidity in Hong Kong community.
designSex-specific age-period-cohort analysis with repeated cross-sectional surveys.
settingA territory-wide population survey database.
participants69 636 adults aged 35 or above who participated in the surveys in 1999, 2001, 2005 or 2008.
main outcome measuresMorbidity burden was operationalised as number of chronic conditions from a list of 14, while multimorbidity was defined as a dichotomous status of whether participants had two or more conditions.
resultsFor both sexes, there was an upward inflection (positive change) of risk of increased morbidity burden starting from cohort 1955-1959. For men born after 1945-1954, there was a trend of lower risk (relative risk=0.63, 95% CI 0.50 to 0.80 for 1950-1954 vs 1935-1939) which continued through subsequent cohorts but with no further declines. In women, there had been a gradual increase of risk, although only significant for cohort 1970-1974 (relative risk=1.90, 95% CI 1.08 to 1.34 vs 1935-1939). Similar results were found for dichotomous multimorbidity status.
conclusionsThe trend of lower risk starting from men born in 1945-1954 may be due to a persistent decline in smoking rates since the 1980s. On the other hand, the childhood obesity epidemic starting from the late 1950s coincided with the observed upward inflection of risk for both sexes, that is, notably more drastic increase of risk in women and the levelling-off of the decline of risk in men. These findings highlight that the cohort effects on morbidity burden and multimorbidity may be sex-specific and contextual. By examining such effects in different world populations, localised sex-specific and generation-specific risk factors can be identified to inform policy-making.
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