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Concept
Multimorbidity
Summary
Multimorbidity, also known as multiple long-term conditions (MLTC), means living with two or more chronic illnesses. For example, a person could have diabetes, heart disease and depression at the same time. Multimorbidity can have a significant impact on people's health and wellbeing. It also poses a complex challenge to healthcare systems which are traditionally focused on individual diseases. Multiple long-term conditions are much more common in older people, affecting more than half of those over 65, however, they can also be found in young people.
The concept of multiple long-term conditions is not clearly defined and may be referred to by various names.
Multimorbidity is often referred to as comorbidity even though the two are considered distinct clinical scenarios.
Comorbidity means that one 'index' condition is the focus of attention, and others are viewed in relation to this. In contrast, multimorbidity describes someone having two or more long-term (chronic) conditions without any of them holding priority over the others. This distinction is important in how the healthcare system treats people and helps making clear the specific settings in which the use of one or the other term can be preferred. Multimorbidity offers a more general and person-centered concept that allows focusing on all of the patient's symptoms and providing a more holistic care. In other settings, for example in pharmaceutical research, comorbidity might often be the more useful term to use.
The broad definition of multimorbidity, consistent with what is used by most researchers, the WHO and the UK's Academy of Medical Sciences is the "co-existence of two or more chronic conditions". These can be physical non-communicable diseases, infectious and mental health conditions in any possible combinations and they may or may not interact with each other. When the co-existing conditions have similar origins or treatments the terms used is concordant multimorbidity, while discordant multimorbidity is used to refer to conditions that appear to be unrelated to each other.
Official source
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