Evidence map›Paper›PMID 41458238›Full record

ArticleBMJ public health2025

Inequality in the accumulation of diseases and medications among older adults: a longitudinal cohort study 2016-2021.

Tran Quoc Bao Tran, Stefanie Lip, Chris McParland, Barbara I Nicholl, Jocelyn M Friday, Jim Lewsey, Daniel Mackay, Ruth Dundas, Clea Du Toit, Alan Stevenson and 3 more

Abstract read
In one paragraph

Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Review
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

13 authors.

Tran Quoc Bao TranSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0001-6829-6432
Stefanie LipSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0001-8515-9018
Chris McParlandSchool of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0003-1575-3390
Barbara I NichollSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0001-5639-0130
Jocelyn M FridaySchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-1658-3883
Jim LewseySchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-3811-8165
Daniel MackaySchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0001-5381-7098
Ruth DundasSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-3836-4286
Clea Du ToitDigital Health Validation Lab, Living Lab, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-7221-6965
Alan StevensonSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0009-0001-8728-3730
Jill P PellSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0002-8898-7035
Frances S MairSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0001-9780-1135
Sandosh PadmanabhanSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID https://orcid.org/0000-0003-3869-5808

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Socioeconomic deprivation is a major driver of multimorbidity (multiple long-term conditions, MLTCs) and polypharmacy in ageing populations. However, it is unclear how these inequalities evolve over time or influence early disease progression. Methods: We conducted a population-based longitudinal study of 414 746 adults aged ≥51 years in Greater Glasgow and Clyde, Scotland, using linked administrative health records. Participants were followed at three timepoints (2016, 2019, 2021), with socioeconomic status defined by Scottish Index of Multiple Deprivation (SIMD) deciles. Outcomes included prevalence and progression of MLTCs and medication burden. Zero-inflated negative binomial (ZINB) models estimated the burden of disease and prescribing, and the likelihood of remaining disease-free or prescription-free, adjusted for age and sex. Results: Multimorbidity and prescription burden increased over time across all groups. In 2021, 26.0% of individuals in the most deprived decile (SIMD1) had ≥5 conditions compared with 13.8% in the least deprived (SIMD10). From 2016 to 2021, individuals in SIMD10 were nearly 40% less likely to progress from a single condition to five or more (risk ratio=0.62 (0.60 to 0.63)) compared with SIMD1. ZINB models showed lower expected MLTC counts (incidence rate ratio (IRR)=0.59 (0.58 to 0.60)) and medication burden (IRR=0.91 (0.90 to 0.91)) in SIMD10, but also lower odds of remaining completely disease-free (OR=0.65 (0.63 to 0.68)) or prescription-free (OR=0.44 (0.41 to 0.47)). Findings were consistent in survivor-only sensitivity analyses (n=360 683). Conclusions: Socioeconomic deprivation shapes disease and treatment trajectories from the earliest stages. Individuals in deprived areas experience faster accumulation of conditions and medications. These disparities are not explained by survival differences and highlight the need for equity-focused prevention, tailored care pathways and systems that address the social complexity of multimorbidity.

Indexed as

ComorbidityEpidemiologyPublic Health

Identifiers

PMID41458238
PMCPMC12742123

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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.