Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study

Ali Köse; Eylül Tutal Altaş; Zeynep Sedef Varol; Buşra Tozduman; Gül Ergör; Alp Ergör

doi:10.20518/tjph.1766072

Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study

Abstract

Abstract Objective: This study aims to estimate the incidence of multimorbidity between 2009 and 2023 and to identify its key determinants. Methods: This retrospective cohort study was conducted using a sub-cohort derived from the 2009-Balçova’s Heart Study (2009-BAK), carried out in Balçova, İzmir. In the current study, the presence of multimorbidity was considered as the outcome variable, while age groups, gender, and education level were included as independent variables. The effect of independent variables on the dependent variable was analyzed using Cox regression analysis. The incidence rates of multimorbidity were calculated according to gender and age groups. Results: Among the participants, 66.7% were women and 8.2% were aged 70 years and older; hypertension was the most prevalent chronic condition, affecting 37.2% of the total sample. The incidence rate of multimorbidity was calculated as 27.3 per 1,000 person-years overall, with 27.6 observed in females and 41.4 among individuals aged 70 years and above. According to the results of multivariable Cox regression analysis, age was strongly associated with an increased risk of multimorbidity; individuals aged 70 and above had a 3.68-fold higher risk compared to those aged 30–39 (HR: 3.68, 95% CI: 2.63–5.16, p < 0.001). Conclusion: This study is the first cohort study conducted in our country on the epidemiology of multimorbidity. This study’s results highlight the importance of targeted preventive strategies for older populations to address the growing burden of multimorbidity. Keywords: multimorbidity, incidence, cohort study

Keywords

Supporting Institution

None.

Project Number

none.

Ethical Statement

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Dokuz Eylül University Non-Interventional Research Ethics Committee under the decision dated October 26, 2022 (decision no: 2022/34-30) for the project titled “Evaluation of Serum Albumin, Creatinine, Uric Acid, Magnesium and CRP Levels in Relation to Type 2 Diabetes Mellitus, Cardiovascular Diseases, Dementia and Alzheimer’s Disease: The Balçova Heart (BAK) Prospective Cohort Study”. In addition, the thesis study based on this project was approved by the Dokuz Eylül University Non-Interventional Research Ethics Committee with the decision dated October 9, 2024 (decision no: 2024/33-06) under the title “Clusters and Determinants of Multimorbidity in the Community, and the Impact of Multimorbidity on Healthcare Utilization, Quality of Life, and Patient Activation”.

Thanks

We would like to thank the Balçova’s Heart (BAK) Project team for their support in providing the study data.

References

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Details

Primary Language

English

Subjects

Public Health (Other)

Journal Section

Research Article

Authors

Ali Köse ^*
0000-0002-8583-8982
Türkiye

Eylül Tutal Altaş
0000-0001-6404-5791
Türkiye

Zeynep Sedef Varol
0000-0002-6724-1488
Türkiye

Buşra Tozduman
0000-0003-0372-6280
Türkiye

Gül Ergör
0000-0002-2263-7526
Türkiye

Alp Ergör
0000-0002-8654-4994
Türkiye

Early Pub Date

December 15, 2025

Publication Date

December 30, 2025

Submission Date

August 15, 2025

Acceptance Date

October 12, 2025

Published in Issue

Year 2025 Volume: 23 Number: 3

DOI

https://doi.org/10.20518/tjph.1766072

IZ

https://izlik.org/JA46KW43AW

Cite

RIS / Bibtex

APA

Köse, A., Tutal Altaş, E., Varol, Z. S., Tozduman, B., Ergör, G., & Ergör, A. (2025). Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study. Turkish Journal of Public Health, 23(3), 246-253. https://doi.org/10.20518/tjph.1766072

AMA

1.Köse A, Tutal Altaş E, Varol ZS, Tozduman B, Ergör G, Ergör A. Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study. TJPH. 2025;23(3):246-253. doi:10.20518/tjph.1766072

Chicago

Köse, Ali, Eylül Tutal Altaş, Zeynep Sedef Varol, Buşra Tozduman, Gül Ergör, and Alp Ergör. 2025. “Incidence Rate and Determinants of Multimorbidity in the Community: A Retrospective Cohort Study”. Turkish Journal of Public Health 23 (3): 246-53. https://doi.org/10.20518/tjph.1766072.

EndNote

Köse A, Tutal Altaş E, Varol ZS, Tozduman B, Ergör G, Ergör A (December 1, 2025) Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study. Turkish Journal of Public Health 23 3 246–253.

IEEE

[1]A. Köse, E. Tutal Altaş, Z. S. Varol, B. Tozduman, G. Ergör, and A. Ergör, “Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study”, TJPH, vol. 23, no. 3, pp. 246–253, Dec. 2025, doi: 10.20518/tjph.1766072.

ISNAD

Köse, Ali - Tutal Altaş, Eylül - Varol, Zeynep Sedef - Tozduman, Buşra - Ergör, Gül - Ergör, Alp. “Incidence Rate and Determinants of Multimorbidity in the Community: A Retrospective Cohort Study”. Turkish Journal of Public Health 23/3 (December 1, 2025): 246-253. https://doi.org/10.20518/tjph.1766072.

JAMA

1.Köse A, Tutal Altaş E, Varol ZS, Tozduman B, Ergör G, Ergör A. Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study. TJPH. 2025;23:246–253.

MLA

Köse, Ali, et al. “Incidence Rate and Determinants of Multimorbidity in the Community: A Retrospective Cohort Study”. Turkish Journal of Public Health, vol. 23, no. 3, Dec. 2025, pp. 246-53, doi:10.20518/tjph.1766072.

Vancouver

1.Ali Köse, Eylül Tutal Altaş, Zeynep Sedef Varol, Buşra Tozduman, Gül Ergör, Alp Ergör. Incidence rate and determinants of multimorbidity in the community: A retrospective cohort study. TJPH. 2025 Dec. 1;23(3):246-53. doi:10.20518/tjph.1766072