{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:40:45Z","timestamp":1792276845724,"version":"4.4.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To estimate the prevalence of multimorbidity among European community-dwelling adults, as well as to analyse the association with gender, age, education, self-rated health, loneliness, quality of life, size of social network, Body Mass Index (BMI) and disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted, and community-dwelling participants aged 50+ (n = 63,844) from 17 European countries were selected. Multimorbidity was defined as presenting two or more health conditions. The independent variables were gender, age group, educational level, self-rated health, loneliness, size of network, quality of life, BMI and disability (1+ limitations of basic activities of daily living). Poisson regression models with robust variance were fit for bivariate and multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of multimorbidity was 28.2% (confidence interval\u2013CI 95%: 27.5.8\u201329.0) among men and 34.5% (CI95%: 34.1\u201335.4) among women. The most common health conditions were cardiometabolic and osteoarticular diseases in both genders, and emotional disorders in younger women. A large variability in the prevalence of multimorbidity in European countries was verified, even between countries of the same region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multimorbidity was associated with sociodemographic and physical characteristics, self-rated health, quality of life and loneliness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0246623","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T18:30:00Z","timestamp":1613068200000},"page":"e0246623","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":72,"title":["Multimorbidity and its associated factors among adults aged 50 and over: A cross-sectional study in 17 European countries"],"prefix":"10.1371","volume":"16","author":[{"given":"Dyego Leandro","family":"Bezerra de Souza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8262-7672","authenticated-orcid":true,"given":"Albert","family":"Oliveras-Fabregas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Espelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8830-8880","authenticated-orcid":true,"given":"Marina","family":"Bosque-Prous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"de Camargo Cancela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"Teixid\u00f3-Compa\u00f1\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Jerez-Roig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"pone.0246623.ref001","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1093\/ageing\/afw044","article-title":"Associations between multimorbidity, healthcare utilisation and health status: evidence from 16 European countries","volume":"45","author":"R Palladino","year":"2016","journal-title":"Age Ageing"},{"key":"pone.0246623.ref002","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/s12916-015-0402-8","article-title":"The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?","volume":"13","author":"P Arokiasamy","year":"2015","journal-title":"BMC Med"},{"key":"pone.0246623.ref003","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12963-017-0126-4","article-title":"Evidence-based design recommendations for prevalence studies on multimorbidity: improving comparability of estimates","volume":"15","author":"BM Holzer","year":"2017","journal-title":"Popul Health Metrics"},{"key":"pone.0246623.ref004","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1093\/gerona\/glv128","article-title":"Global Multimorbidity Patterns: A Cross-Sectional, Population-Based, Multi-Country Study","volume":"71","author":"N Garin","year":"2016","journal-title":"GERONA"},{"key":"pone.0246623.ref005","doi-asserted-by":"crossref","first-page":"e102149","DOI":"10.1371\/journal.pone.0102149","article-title":"Prevalence, Determinants and Patterns of Multimorbidity in Primary Care: A Systematic Review of Observational Studies","volume":"9","author":"C Violan","year":"2014","journal-title":"PLoS ONE"},{"key":"pone.0246623.ref006","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.arr.2011.03.003","article-title":"Aging with multimorbidity: a systematic review of the literature","volume":"10","author":"A Marengoni","year":"2011","journal-title":"Ageing Res Rev"},{"key":"pone.0246623.ref007","doi-asserted-by":"crossref","first-page":"4","DOI":"10.15256\/joc.2016.6.72","article-title":"Multimorbidity: What Do We Know? What Should We Do?","volume":"6","author":"R Navickas","year":"2016","journal-title":"J Comorb"},{"key":"pone.0246623.ref008","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.1016\/S2468-2667(17)30074-9","article-title":"Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe","volume":"2","author":"M Kivim\u00e4ki","year":"2017","journal-title":"Lancet Public Health"},{"key":"pone.0246623.ref009","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.puhe.2016.05.014","article-title":"Association between body mass index and prevalence of multimorbidity: a cross-sectional study","volume":"139","author":"D Jovic","year":"2016","journal-title":"Public Health"},{"key":"pone.0246623.ref010","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/1477-7525-2-51","article-title":"Multimorbidity and quality of life in primary care: a systematic review","volume":"2","author":"M Fortin","year":"2004","journal-title":"Health Qual Life Outcomes"},{"key":"pone.0246623.ref011","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/s12877-018-0928-7","article-title":"Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty","volume":"18","author":"A Rivera-Almaraz","year":"2018","journal-title":"BMC Geriatr"},{"key":"pone.0246623.ref012","doi-asserted-by":"crossref","first-page":"100903","DOI":"10.1016\/j.arr.2019.04.005","article-title":"Multimorbidity and quality of life: systematic literature review and meta-analysis","volume":"53","author":"TT Makovski","year":"2019","journal-title":"Ageing Res Rev"},{"key":"pone.0246623.ref013","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.exger.2017.10.001","article-title":"All-cause mortality and multimorbidity in older adults: The role of social support and loneliness","volume":"99","author":"B Olaya","year":"2017","journal-title":"Exp Gerontol"},{"key":"pone.0246623.ref014","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s10433-016-0375-2","article-title":"Predictors of social leisure activities in older Europeans with and without multimorbidity","volume":"13","author":"H Galenkamp","year":"2016","journal-title":"Eur J Ageing"},{"key":"pone.0246623.ref015","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12877-018-0705-7","article-title":"Multimorbidity patterns in the elderly: a prospective cohort study with cluster analysis","volume":"18","author":"M Guisado-Clavero","year":"2018","journal-title":"BMC Geriatr"},{"key":"pone.0246623.ref016","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/gerona\/glq208","article-title":"The Measurement of Multiple Chronic Diseases\u2014A Systematic Review on Existing Multimorbidity Indices","volume":"66A","author":"C Diederichs","year":"2011","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"pone.0246623.ref017","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/ije\/dyt088","article-title":"Data Resource Profile: The Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"42","author":"A B\u00f6rsch-Supan","year":"2013","journal-title":"Int J Epidemiol"},{"key":"pone.0246623.ref018","article-title":"Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 6. Release version: 6.0.0. SHARE-ERIC","author":"A. B\u00f6rsch-Supan","year":"2017","journal-title":"Dataset"},{"key":"pone.0246623.ref019","volume-title":"Survey participation in the survey of health, ageing and retirement in Europe (SHARE), Wave 1\u20137. Based on Release 7.0.0","author":"M Bergmann","year":"2017"},{"key":"pone.0246623.ref020","first-page":"165","article-title":"Measurement and adjustment of non-response bias based on non-response surveys: the case of Belgium and Norway in the European Social Survey Round 3","volume":"4","author":"H Matsuo","year":"2010","journal-title":"Surv Res Methods"},{"key":"pone.0246623.ref021","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.eurger.2016.11.010","article-title":"Disparities in multimorbidity across Europe\u2013Findings from the SHARE Survey","volume":"8","author":"CR Nielsen","year":"2017","journal-title":"Eur Geriatr Med"},{"key":"pone.0246623.ref022","volume-title":"International Standard Classification of Education-ISCED 1997: November 1997","author":"Unesco","year":"1997"},{"key":"pone.0246623.ref023","volume-title":"SHARE Wave 5: Innovations & Methodology","author":"F Malter","year":"2015"},{"key":"pone.0246623.ref024","volume-title":"An evaluation of the CASP-12 scale used in the Survey of Health, Ageing and Retirement in Europe (SHARE) to measure Quality of Life among people aged 50","author":"C Borrat-Besson","year":"2015"},{"key":"pone.0246623.ref025","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/0164027504268574","article-title":"A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies.","volume":"26","author":"ME Hughes","year":"2004","journal-title":"Res Aging"},{"key":"pone.0246623.ref026","doi-asserted-by":"crossref","first-page":"5797","DOI":"10.1073\/pnas.1219686110","article-title":"Social isolation, loneliness, and all-cause mortality in older men and women","volume":"110","author":"A Steptoe","year":"2013","journal-title":"Proc Natl Acad Sci U S A"},{"key":"pone.0246623.ref027","first-page":"18","article-title":"Social network measurement in SHARE wave four","volume":"4","author":"H Litwin","year":"2013","journal-title":"SHARE wave"},{"key":"pone.0246623.ref028","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/0164027515581422","article-title":"Social network, activity participation, and cognition: A complex relationship","volume":"38","author":"H Litwin","year":"2016","journal-title":"Res Aging"},{"key":"pone.0246623.ref029","first-page":"105","article-title":"Applied Prevalence Ratio estimation with different Regression models: An example from a cross-national study on substance use research","volume":"29","author":"A Espelt","year":"2017","journal-title":"Adicciones"},{"key":"pone.0246623.ref030","first-page":"257","article-title":"Considerations on the use of Odds Ratio versus Prevalence or Proportion Ratio","volume":"31","author":"A Espelt","year":"2019","journal-title":"Adicciones"},{"key":"pone.0246623.ref031","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jclinepi.2011.11.006","article-title":"How to weight chronic diseases in multimorbidity indices? Development of a new method on the basis of individual data from five population-based studies","volume":"65","author":"CP Diederichs","year":"2012","journal-title":"J Clin Epidemiol"},{"key":"pone.0246623.ref032","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/eurpub\/cky098","article-title":"Defining and measuring multimorbidity: a systematic review of systematic reviews","volume":"29","author":"MC Johnston","year":"2019","journal-title":"Eur J Public Health"},{"key":"pone.0246623.ref033","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s00038-018-1114-6","article-title":"Chronic conditions and multimorbidity in a primary care population: a study in the Swiss Sentinel Surveillance Network (Sentinella)","volume":"63","author":"M Gn\u00e4dinger","year":"2018","journal-title":"Int J Public Health"},{"key":"pone.0246623.ref034","first-page":"e010126","article-title":"Prevalence of multimorbidity and its association with outcomes in older emergency general surgical patients: an observational study","author":"J Hewitt","year":"2016","journal-title":"Open Access"},{"key":"pone.0246623.ref035","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3390\/ijerph13040391","article-title":"How Does Sex Influence Multimorbidity? Secondary Analysis of a Large Nationally Representative Dataset","volume":"13","author":"K Agur","year":"2016","journal-title":"IJERPH"},{"key":"pone.0246623.ref036","doi-asserted-by":"crossref","first-page":"e0174322","DOI":"10.1371\/journal.pone.0174322","article-title":"Prevalence of multimorbidity in the Brazilian adult population according to socioeconomic and demographic characteristics","volume":"12","author":"JN de Carvalho","year":"2017","journal-title":"PLoS ONE"},{"key":"pone.0246623.ref037","doi-asserted-by":"crossref","first-page":"e0141155","DOI":"10.1371\/journal.pone.0141155","article-title":"Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis","volume":"10","author":"Q Foguet-Boreu","year":"2015","journal-title":"PLoS ONE"},{"key":"pone.0246623.ref038","doi-asserted-by":"crossref","first-page":"e0171813","DOI":"10.1371\/journal.pone.0171813","article-title":"Epidemiology of multimorbidity within the Brazilian adult general population: Evidence from the 2013 National Health Survey (PNS 2013)","volume":"12","author":"M Rzewuska","year":"2017","journal-title":"PLoS ONE"},{"key":"pone.0246623.ref039","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/ije\/dyx259","article-title":"Cohort Profile: The Epidemiology of Chronic Diseases and Multimorbidity. The EpiChron Cohort Study","volume":"47","author":"A Prados-Torres","year":"2018","journal-title":"Int J Epidemiol"},{"key":"pone.0246623.ref040","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/jep.12587","article-title":"\u2018Multimorbidity\u2019 as the manifestation of network disturbances: \u2018Multimorbidity\u2019 as network disturbances","volume":"23","author":"JP Sturmberg","year":"2017","journal-title":"J Eval Clin Pract"},{"key":"pone.0246623.ref041","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/jep.12599","article-title":"Multimorbidity: a sociological perspective of systems: Multimorbidity","volume":"23","author":"C Walker","year":"2017","journal-title":"J Eval Clin Pract"},{"key":"pone.0246623.ref042","doi-asserted-by":"crossref","first-page":"e0207649","DOI":"10.1371\/journal.pone.0207649","article-title":"Lifestyle factors and high body mass index are associated with different multimorbidity clusters in the Brazilian population","volume":"13","author":"JN de Carvalho","year":"2018","journal-title":"PLoS ONE"},{"key":"pone.0246623.ref043","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1186\/s12889-017-4314-8","article-title":"Social disparities in the prevalence of multimorbidity\u2013A register-based population study","volume":"17","author":"ML Schi\u00f8tz","year":"2017","journal-title":"BMC Public Health"},{"key":"pone.0246623.ref044","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1186\/s12889-017-4833-3","article-title":"Prevalence of multimorbidity in Germany: impact of age and educational level in a cross-sectional study on 19,294 adults","volume":"17","author":"M-T Puth","year":"2017","journal-title":"BMC Public Health"},{"key":"pone.0246623.ref045","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1093\/ije\/dyn051","article-title":"Inequalities in health by social class dimensions in European countries of different political traditions","volume":"37","author":"A Espelt","year":"2008","journal-title":"Int J Epidemiol"},{"key":"pone.0246623.ref046","unstructured":"Struckmann V, Quentin W, Busse R, Ginneken E van. How to strengthen financing mechanisms to promote care for people with multimorbidity in Europe? Utrecht, The Netherlands; 2017 p. 30. Report No.: 24."},{"key":"pone.0246623.ref047","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0140-6736(12)60240-2","article-title":"Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study","volume":"380","author":"K Barnett","year":"2012","journal-title":"Lancet"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0246623","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T18:30:33Z","timestamp":1613068233000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0246623"}},"subtitle":[],"editor":[{"given":"Brecht","family":"Devleesschauwer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,11]]},"references-count":47,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0246623","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,11]]}}}