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000298965 1001_ $$aManfredi, Luca$$b0
000298965 245__ $$aA longitudinal Analysis of the Association between Socioeconomic Position and Multimorbidity in the European Prospective Investigation into Cancer and Nutrition Study.
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000298965 520__ $$aThe association between socioeconomic position (SEP) and non-communicable diseases (NCDs) is well established, but its role in driving multimorbidity remains unclear. Multimorbidity, defined as the co-occurrence of more than one chronic condition, is linked to higher mortality and reduced quality of life. This study investigates the association between SEP and multimorbidity using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Incident cases of cancer, type 2 diabetes (T2D), and cardiovascular diseases (CVDs) were analysed alongside lifestyle factors such as smoking status, alcohol intake, body mass index (BMI), physical activity and diet. Multimorbidity was defined as the presence of at least two of the studied NCDs. SEP was assessed using the Relative Index of Inequality (RII) and categorized into high, medium, and low SEP. The cohort included 277 302 participants (60.7% women) from seven countries, enrolled between 1992-2000 and followed until the first diagnosis, end of follow-up (31/12/2007), or death. For transitions to multimorbidity, follow-up extended from the first diagnosis to the second diagnosis, end of follow-up, or death. Multistate models were used to examine the nine possible transitions to first diagnoses and multimorbidity combinations. Lifestyle factors were risk factors for all the transitions, except alcohol intake. In the main model, not stratified by sex, low SEP was associated with higher risks of progressing from cancer to CVD (Hazard Ratio (HR): 1.23, CI: 1.02-1.50), CVD to T2D (HR: 1.35, CI: 1.07-1.71), and cancer to T2D (HR: 1.37, CI: 1.10-1.69). These findings highlight the persistent influence of social inequalities on the risk of multimorbidity, even in individuals with an existing chronic condition.
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000298965 7001_ $$aSodano, Barbara$$b1
000298965 7001_ $$aRaganato, Chiara$$b2
000298965 7001_ $$aBuscema, Federica$$b3
000298965 7001_ $$aMilani, Lorenzo$$b4
000298965 7001_ $$aCatalano, Alberto$$b5
000298965 7001_ $$aFreisling, Heinz$$b6
000298965 7001_ $$aFerrari, Pietro$$b7
000298965 7001_ $$aAbraha, Alem$$b8
000298965 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b9$$udkfz
000298965 7001_ $$0P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aKatzke, Verena$$b10$$udkfz
000298965 7001_ $$aPanico, Salvatore$$b11
000298965 7001_ $$aAntoniussen, Christian Skødt$$b12
000298965 7001_ $$aDahm, Christina C$$b13
000298965 7001_ $$aTin, Sandar Tin$$b14
000298965 7001_ $$aVermeulen, Roel$$b15
000298965 7001_ $$aVaartjes, Ilonca$$b16
000298965 7001_ $$aTjønneland, Anne$$b17
000298965 7001_ $$aOlsen, Anja$$b18
000298965 7001_ $$aColorado-Yohar, Sandra$$b19
000298965 7001_ $$aGrioni, Sara$$b20
000298965 7001_ $$aGunter, Marc J$$b21
000298965 7001_ $$aSchulze, Matthias B$$b22
000298965 7001_ $$aCordova, Reynalda$$b23
000298965 7001_ $$aSánchez, Maria-Jose$$b24
000298965 7001_ $$aBonet, Catalina Bonet$$b25
000298965 7001_ $$aTumino, Rosario$$b26
000298965 7001_ $$aMokoroa, Olatz$$b27
000298965 7001_ $$aMasala, Giovanna$$b28
000298965 7001_ $$aEslava, Marcela Guevara$$b29
000298965 7001_ $$aVerschuren, Monique$$b30
000298965 7001_ $$aSacerdote, Carlotta$$b31
000298965 7001_ $$aRicceri, Fulvio$$b32
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