Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study

Background With rising longevity, multimorbidity is an increasingly important challenge for healthcare systems. We describe trends in the prevalence and incidence of multimorbidity across socioeconomic groups in Catalonia. Methods We use a random sample of 1 551 126 individuals (22% of the Catalan p...

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Authors: Permanyer, Iñaki, Gumà, Jordi, Trias Llimós, Sergi, Solé-Auró, Aïda
Format: article
Status:Published version
Publication Date:2026
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/72669
Online Access:https://hdl.handle.net/10230/72669
http://dx.doi.org/10.1093/ije/dyaf218
Access Level:Open access
Keyword:Aging
Multimorbidity
Inequalities
Mortality
Health registers
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spelling Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort studyPermanyer, IñakiGumà, JordiTrias Llimós, SergiSolé-Auró, AïdaAgingMultimorbidityInequalitiesMortalityHealth registersBackground With rising longevity, multimorbidity is an increasingly important challenge for healthcare systems. We describe trends in the prevalence and incidence of multimorbidity across socioeconomic groups in Catalonia. Methods We use a random sample of 1 551 126 individuals (22% of the Catalan population, for whom we have the complete primary care health records) and follow them from 2010 until 2021. We document the age- and sex-specific prevalence and incidence of multimorbidity stratifying by income groups and birth cohorts. Logistic regression models are used to estimate the association between multimorbidity and mortality. Results Between 2010 and 2021, the prevalence of multimorbidity, higher among women, has increased for both sexes and all cohorts in our analysis. Importantly, each cohort attains the same ages, with higher multimorbidity prevalence than their predecessors had 10 years ago. Older generations are mostly affected by degenerative diseases, while younger age groups are more affected by mental health problems. Incidence tends to be higher among the older cohorts across all adult ages. We observe a strong socioeconomic gradient, with lower-income individuals experiencing worse multimorbidity prevalence and incidence. Such a gradient is persistent and becomes more pronounced at the end of the study period. Across all age groups, individuals experiencing multimorbidity have a higher risk of dying than those who do not. Conclusion The documented increases in multimorbidity alongside its socioeconomic gradients suggest that preventive strategies are urgently needed to defer or prevent its onset and slow its progression-especially among younger generations.Support from the ERC CoG HEALIN project (864616; PI: I.P.) is gratefully acknowledged. I.P. and A.S.A. acknowledge financial support for this research from the Spanish Ministry of Science and Innovation under the "Generación de Conocimiento" Project LONGHEALTH [PID2021-128892OB-I00; PI: I.P. (CED-CERCA); A.S.A. (Universitat Pompeu Fabra)]. This paper has also received support from the 2021 SGR 00957 project (PI: A.S.A.) and the 2021 SGR 01337 project (PI: I.P.) funded by the Agency for Management of University and Research Grants (AGAUR). S.T.L. and J.G. acknowledge funding from the Spanish State Research Agency (RYC2021-033123-I, PID2023-148727OA-I00, and RYC2022-037781-I funded by MICIU/AEI/10.13039/501100011033 and by ESF+, respectively).Oxford University Press2026202620262026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/72669http://dx.doi.org/10.1093/ije/dyaf218reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésInternational Journal of Epidemiology. 2026 Feb;55(1):dyaf218info:eu-repo/grantAgreement/EC/H2020/864616info:eu-repo/grantAgreement/ES/3PE/PID2021-128892OB-I00info:eu-repo/grantAgreement/ES/3PE/PID2023-148727OA-I00© The Author(s) 2026. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Attribution 4.0 Internationalhttps://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/726692026-06-12T07:21:37Z
dc.title.none.fl_str_mv Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
title Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
spellingShingle Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
Permanyer, Iñaki
Aging
Multimorbidity
Inequalities
Mortality
Health registers
title_short Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
title_full Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
title_fullStr Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
title_full_unstemmed Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
title_sort Multimorbidity trends in Catalonia, 2010-2021: a population-based cohort study
dc.creator.none.fl_str_mv Permanyer, Iñaki
Gumà, Jordi
Trias Llimós, Sergi
Solé-Auró, Aïda
author Permanyer, Iñaki
author_facet Permanyer, Iñaki
Gumà, Jordi
Trias Llimós, Sergi
Solé-Auró, Aïda
author_role author
author2 Gumà, Jordi
Trias Llimós, Sergi
Solé-Auró, Aïda
author2_role author
author
author
dc.subject.none.fl_str_mv Aging
Multimorbidity
Inequalities
Mortality
Health registers
topic Aging
Multimorbidity
Inequalities
Mortality
Health registers
description Background With rising longevity, multimorbidity is an increasingly important challenge for healthcare systems. We describe trends in the prevalence and incidence of multimorbidity across socioeconomic groups in Catalonia. Methods We use a random sample of 1 551 126 individuals (22% of the Catalan population, for whom we have the complete primary care health records) and follow them from 2010 until 2021. We document the age- and sex-specific prevalence and incidence of multimorbidity stratifying by income groups and birth cohorts. Logistic regression models are used to estimate the association between multimorbidity and mortality. Results Between 2010 and 2021, the prevalence of multimorbidity, higher among women, has increased for both sexes and all cohorts in our analysis. Importantly, each cohort attains the same ages, with higher multimorbidity prevalence than their predecessors had 10 years ago. Older generations are mostly affected by degenerative diseases, while younger age groups are more affected by mental health problems. Incidence tends to be higher among the older cohorts across all adult ages. We observe a strong socioeconomic gradient, with lower-income individuals experiencing worse multimorbidity prevalence and incidence. Such a gradient is persistent and becomes more pronounced at the end of the study period. Across all age groups, individuals experiencing multimorbidity have a higher risk of dying than those who do not. Conclusion The documented increases in multimorbidity alongside its socioeconomic gradients suggest that preventive strategies are urgently needed to defer or prevent its onset and slow its progression-especially among younger generations.
publishDate 2026
dc.date.none.fl_str_mv 2026
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/72669
http://dx.doi.org/10.1093/ije/dyaf218
url https://hdl.handle.net/10230/72669
http://dx.doi.org/10.1093/ije/dyaf218
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Epidemiology. 2026 Feb;55(1):dyaf218
info:eu-repo/grantAgreement/EC/H2020/864616
info:eu-repo/grantAgreement/ES/3PE/PID2021-128892OB-I00
info:eu-repo/grantAgreement/ES/3PE/PID2023-148727OA-I00
dc.rights.none.fl_str_mv Attribution 4.0 International
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution 4.0 International
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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