Socio-economic and lifestyle determinants of multi-morbidity among elderly patients attending tertiary level hospitals in Bangladesh

Abstract

Background: Multimorbidity (MM), the co-existence of two or more chronic diseases, is not just a medical condition but a significant public health concern for many developing countries, including Bangladesh. The limited information on MM among the older population in Bangladesh has driven us to conduct this study, which is of utmost importance for healthcare professionals and policymakers in formulating effective healthcare strategies. Methods: A cross-sectional study was conducted in randomly selected two public medical college hospitals with a sample of 566 hospitalized elderly patients aged 60 years and above. Respondents’ clinical information on chronic conditions was obtained from hospital reports, and socio-demographic data were collected using a semi-structured questionnaire. Bivariate and multivariate analyses were used to assess the associations among the variables and covariates of MM. Result: MM of the elderly varied substantially by socio-demographic, lifestyle, and economic attributes. Higher age, widowhood, lower education, use of tobacco, and greater economic dependency are conducive to heightened MM likelihood among the elderly. More specifically, females have higher rates of MM than males (64.18% vs. 54.17%). The higher the age, the higher the chances of MM [OR: 1.03; 95% CI 1.04–1.06]. Similarly, economically dependent individuals have higher MM than independent older adults [OR: 3.12; 95% CI 1.88–5.17]. Smoking cigarettes, bidis, tobacco, and other intoxicants (snuff, pan, and pan masala) have a higher likelihood of MM for both males and females. Urban and non-Muslim elderly also have lower odds of MM than their counterparts. Our findings, which highlight the variations in MM based on different socioeconomic and lifestyle determinants, underscore the urgent need for further exploration of determinant-specific variations. This will enable the development of effective preventive measures and specific clinical and public health strategies for targeted prevention and intervention. As revealed by our study, the ‘lifestyle factors’-centered systematic treatment strategy should be prioritized in the care of elderly patients with multimorbidity.