Multimorbidity and quality of life at mid-life: A systematic review of general population studies

Kanesarajah, Jeeva, Waller, Michael, Whitty, Jennifer A. and Mishra, Gita D. (2017) Multimorbidity and quality of life at mid-life: A systematic review of general population studies. Maturitas, 109 53-62. doi:10.1016/j.maturitas.2017.12.004


Author Kanesarajah, Jeeva
Waller, Michael
Whitty, Jennifer A.
Mishra, Gita D.
Title Multimorbidity and quality of life at mid-life: A systematic review of general population studies
Journal name Maturitas   Check publisher's open access policy
ISSN 1873-4111
0378-5122
Publication date 2017-12-06
Year available 2017
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.maturitas.2017.12.004
Open Access Status Not yet assessed
Volume 109
Start page 53
End page 62
Total pages 10
Place of publication Shannon, Clare Ireland
Publisher Elsevier
Language eng
Subject 1300 Biochemistry, Genetics and Molecular Biology
2729 Obstetrics and Gynaecology
Abstract There is substantial multimorbidity at mid-life but little is known about the strength of evidence on multimorbidity and health-related quality of life (HrQoL) at mid-life. This review addresses this gap, focusing on studies of the general population. PubMed, Web of Science, Embase and APA PsycNET databases were screened on 6 March 2017 for original research on multimorbidity and HrQoL in adults aged 40–65 years from the general population. Studies focused on index conditions, using single-item HrQoL measures, unlikely to represent the general population (e.g. primary care), and papers that were not in the English language were excluded. A narrative synthesis was presented due to heterogeneity in the measurement of multimorbidity. Of the 2557 articles, 83 underwent full text screening and 8 were included in the review. Included studies were of moderate to high quality and no exclusions were made on the basis of quality or bias. Multimorbidity was associated with poorer HrQoL at mid-life. Two cross-sectional studies found that adults with multimorbidity at early mid-life reported poorer HrQoL than adults with multimorbidity at late mid-life, while another found the reverse. Two distinct disease clusters were identified: mental health conditions and cardiovascular disease (CVD). Those in the mental health cluster reported poorer HrQoL than those in the CVD cluster, women more so than men. Limitations of the selected studies include lack of longitudinal evidence, use of self-reported conditions and no assessment of disease severity. Multimorbidity is associated with poor HrQoL at mid-life at the population level, with some evidence of differences in association with age and disease cluster and sparse evidence on sex differences. Longitudinal research using a weighted disease severity index and multimorbidity trajectories is needed to strengthen the evidence base.
Keyword General population
Health-related quality of life
Middle age
Multimorbidity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
School of Public Health Publications
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Created: Sun, 24 Dec 2017, 09:55:46 EST