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Role of sociodemographic characteristics on the progression of multimorbidity over time: a longitudinal approach using the Clinical Practice Research Datalink of England
  1. Martina Manna1,
  2. Paolo Mazzola1,2
  1. 1School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
  2. 2Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
  1. Correspondence to Professor Paolo Mazzola, School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza 20900, Italy; paolo.mazzola{at}

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Commentary on: Chen S, Marshall T, Jackson C, et al. Sociodemographic characteristics and longitudinal progression of multimorbidity: A multistate modelling analysis of a large primary care records dataset in England. PLoS Med 2023;20(11): e1004310. doi: 10.1371/journal.pmed.1004310

Implications for practice and research

  • Collecting data about different physiological, psychological and sociodemographic factors is crucial to better understand the progression of multimorbidity, rather than single disease-oriented approaches.

  • Factors that influence the development of multimorbidity seem to precede a subject’s engagement with health services, thus the implementation of preventive strategies should take place early in the disease trajectory, aiming to reduce inequalities between groups with diverse socioeconomic backgrounds and ethnicities.


Multimorbidity is the concomitant presence of ≥2 long-term chronic health conditions in a subject, it is increasingly prevalent with the ageing process and leads to poor health outcomes.1 Previous research has mostly investigated patterns of multimorbidity cross-sectionally, without focusing on its longitudinal nature in terms of accumulation of deficits.2

Theoretically, multimorbidity progresses over time with transitions through various states corresponding to different …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.