Seo, Han Sang;
(2024)
Multimorbidity in population-based longitudinal cohorts:
operationalization, inequalities and risk factors.
Doctoral thesis (Ph.D), UCL (University College London).
![[thumbnail of PhD_HanSangSeo_finalrevised.pdf]](https://discovery.ucl.ac.uk/style/images/fileicons/text.png) |
Text
PhD_HanSangSeo_finalrevised.pdf - Accepted Version Access restricted to UCL open access staff until 1 July 2025. Download (4MB) |
Abstract
Multimorbidity, the presence of two or more long-term conditions in an individual, represents a huge immediate and future challenge for healthcare systems globally. In this thesis, I propose various measures of operationalizing multimorbidity, cross-cohort comparisons of multimorbidity distributions, and its early life risk factors to multimorbidity trajectory. Data are from the 1946 (MRC National Survey of Health and Development -1946 NSHD), 1958 (National Child Development Study -1958 NCDS), and 1970 (British Cohort Study -1970 BCS). Analysis 1. I examined the predictive utility of five multimorbidity operationalizations at age 63 using 16 chronic diseases, to predict 12-year mortality and age 69 functional independence and physical capability. Explained variation for unweighted disease count and weighted disease count were highest compared with other operationalizations. Analysis2. I examined cross-cohort differences of prevalence in 9 common conditions and experiences of multimorbidity in midlife (age 42-43 years) across three British birth cohorts born in 1946, 1958 and 1970. Sex and socioeconomic inequalities in each cohort, and cohort differences in these were also examined. Observable variations in the prevalence of nine individual long-term conditions along with multimorbidity score and multimorbidity cluster across three cohorts were found. Analysis3. I examined the role of early life exposures to smoking at age 20-25 to its levels and trajectories of multimorbidity across adulthood in NSHD-46. Current smokers and 4>pack-years smoking show earlier onset and more rapid progression of multimorbidity, thereby contributing to the widening disparities observed in advanced age, with independent contributions from sex and socioeconomic positions.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Multimorbidity in population-based longitudinal cohorts: operationalization, inequalities and risk factors |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10193522 |
Archive Staff Only
 |
View Item |
