Evidence map›Paper›PMID 39813217›Full record

ArticlePloS one2025

The co-occurrence of multimorbidity and polypharmacy among middle-aged and older adults in Canada: A cross-sectional study using the Canadian Longitudinal Study on Aging (CLSA) and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN).

Kathryn Nicholson, Jennifer Salerno, Sayem Borhan, Benoit Cossette, Dale Guenter, Meredith Vanstone, John Queenan, Michelle Greiver, Michelle Howard, Amanda L Terry and 5 more

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In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Kathryn NicholsonDepartment of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.ORCID 0000-0002-9534-4724
Jennifer SalernoDepartment of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Sayem BorhanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Benoit CossetteFaculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.
Dale GuenterDepartment of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Meredith VanstoneDepartment of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
John QueenanDepartment of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Michelle GreiverDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Michelle HowardDepartment of Family Medicine, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0001-8127-5492
Amanda L TerryDepartment of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Tyler WilliamsonDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Lauren E GriffithDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Martin FortinDepartment of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
Saverio StrangesDepartment of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Dee ManginDepartment of Family Medicine, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is an increasing prevalence of multiple conditions (multimorbidity) and multiple medications (polypharmacy) across many populations. Previous literature has focused on the prevalence and impact of these health states separately, but there is a need to better understand their co-occurrence. METHODS AND

findingsThis study reported on multimorbidity and polypharmacy among middle-aged and older adults in two national datasets: the Canadian Longitudinal Study on Aging (CLSA) and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Using consistent methodology, we conducted a cross-sectional analysis of CLSA participants and CPCSSN patients aged 45 to 85 years as of 2015. When multimorbidity was defined as two or more conditions, the prevalence was 66.7% and 52.0% in the CLSA and CPCSSN cohorts, respectively. The prevalence of polypharmacy was 14.9% in the CLSA cohort and 22.6% in the CPCSSN cohort when defined as five or more medications. Using the same cut-points, the co-occurrence of multimorbidity and polypharmacy was similar between the two cohorts (CLSA: 14.3%; CPCSSN: 13.5%). Approximately 20% of older adults (65 to 85 years) were living with both multimorbidity and polypharmacy (CLSA: 21.4%; CPCSSN: 18.3%), as compared to almost 10% of middle-aged adults (45 to 64 years) living with this co-occurrence (CLSA: 9.2%; CPCSSN: 9.9%). Across both cohorts and age groups, females had consistently higher estimates of multimorbidity, polypharmacy and the co-occurrence of multimorbidity and polypharmacy.

conclusionsThis study found that multimorbidity and polypharmacy are not interchangeable in understanding population health needs. Approximately one in five older adults in the CLSA and CPCSSN cohorts were living with both multimorbidity and polypharmacy, double the proportion in the younger cohorts. This has implications for future research, as well as health policy and clinical practice, that aim to reduce the occurrence and impact of multimorbidity and unnecessary polypharmacy to enhance the well-being of aging populations.

Indexed as

AgingMultimorbidityPolypharmacyAgedAged, 80 and overCanadaCross-Sectional StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedPrevalencePrimary Health CareSentinel Surveillance

Identifiers

PMID39813217
PMCPMC11734935

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.