Impact of Socioeconomic Inequalities in Transition Between Health, Multimorbidity and Death Amongst Older People

NCT02609516 | Unknown DMC

• 1 other identifier: 14_179
• Study Type: observational
• Target: 1,300,000
• Locations: 1 country
• Sites: 1

Brief Summary

Life expectancy at age 65 in the most deprived fifth of the English population was about 4 years shorter than of the most affluent fifth in 2010. The inverse gradient between mortality and social position is well established. But how disease patterns and multimorbidity (having two or more long term conditions at the same time) impact on differential mortality rates is inconclusive: is it because disadvantaged groups acquire more or more lethal combinations of, diseases over their life course; or, simply, become ill at ages younger than more affluent groups?

Conditions

Multimorbidity

Keywords

Multimorbidity; Health inequalities; Ageing; Mortality

Outcome Measures

Primary Outcomes (5)

• Yearly multimorbidity incidence rate

  Numerator: Of patients with either 0 or 1 chronic diseases as on 1st Jan of the year, all those who become multimorbid by 31st Dec of the year. Denominator: patient years at risk of patients with either 0 or 1 chronic diseases as on 1st Jan of the year

  10 years

• Yearly multimorbidity prevalence

  Numerator: all those with 2 or more listed diseases on 1st July of the year. Denominator: All eligible patients on 1st July of the year, irrespective of disease status on that date.

  10 years

• Yearly all-cause mortality rates

  Numerator: number of deaths until 31st Dec of the year amongst the patients included in the denominator. Denominator: Person years at risk of patients with 0,1,2 or more diseases on 1st Jan of the year.

  10 years

• Overall life expectancy

  Incident rates of transitions between no disease, 1 disease, 2+ diseases, and death.

  10 years

• Health state-specific life expectancies

  Incident rates of transitions between four health states - no disease, 1 disease, 2+ diseases, and death.

  10 years

Secondary Outcomes (1)

• Yearly non-accidental mortality rates

  10 years

Study Arms (2)

Healthy

Patients without any of the pre-specified chronic diseases

Other: This is not an intervention study

Multimorbid

Patients having any two or more of the pre-specified chronic diseases

Other: This is not an intervention study

Interventions

This is not an intervention study OTHER

This study is based on the retrospective analysis of linked electronic health records.

Healthy; Multimorbid

Eligibility Criteria

• Age: 45 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients included in the CALIBER dataset.

You may qualify if:

• Registered with a participating practice that has agreed to data linkage
• Registered with an 'up to standard' participating general practice for at least 1 year
• Aged 45 and over on Jan 1st 2001 or who turn 45 between 1st Jan 2001 and 25th March 2010, irrespective of initial health status.

You may not qualify if:

• Patients with a record unlinked to deprivation due to missing or incomplete postcode of residence.

Sponsors & Collaborators

• University College, London: lead
• University of Leeds: collaborator

Study Sites (1)

University College London

London, WC1 E7H, United Kingdom

Location

Study Officials

• Madhavi Bajekal, PhD

  University College, London

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Epidemiology and Public Health

Study Record Dates

• First Submitted: November 17, 2015
• First Posted: November 20, 2015
• Study Start: January 1, 2015
• Primary Completion: September 1, 2015
• Study Completion: January 1, 2017
• Last Updated: November 20, 2015

Record last verified: 2015-11

Locations

GB (1)