10-year multimorbidity patterns in people with/without rheumatic and musculoskeletal diseases

Why it matters

Rheumatic and musculoskeletal diseases (RMDs) make up a list of over 200 diseases and syndromes, which can affect the joints, connective tissue, cartilage, and tendons. They are usually progressive, painful and are among the most common chronic non-communicable diseases.

The frequency of disability, early death, and physical impairment in people with RMDs is higher than in people without them. In the UK alone, around 8.75 million people were treated for osteoarthritis, the equivalent to a third of all people aged over 45. This negatively affects individuals, social care systems, and health systems, a burden recognised by WHO (World Health Organisation) and the United Nations.

Earlier studies have found that people with RMDs often live with other long term diseases. Multimorbidity, where more than two illnesses or diseases occur in the same person at the same time, is a global health issue which has increased worldwide over the past 20 years – and is expected to keep rising. Although it’s common for people over the age of 65 to have multiple conditions, younger people are also affected.

RMDs also appear to play a key role in some multimorbidity clusters – groups of two or more long term diseases that often occur together. This study used a large electronic primary care database from Wales to look at patterns of 28 long term diseases in people with and without RMDs over 10 years. We also broke down the rates of these diseases by age and sex, examined the link between having RMDs and other diseases, and described patterns of two diseases occurring together.

What we found

We found that people with RMDs were approximately 1.5 times more likely to have multiple long term diseases than people without RMDs, and that these coexisting diseases tended to begin at earlier ages.

This phenomenon was particularly pronounced in women. The most common other diseases in people with RMDs were cardiovascular disease, high blood pressure, and diabetes. Being diagnosed with an RMD was also associated with higher chances of developing other conditions, including:

• deficiency anaemia
• hypothyroidism
• pulmonary circulation disorders
• fluid and electrolyte disorders

Given the high prevalence of RMDs, it is crucial to understand the increased risk of additional long term diseases in patients who live with them. There’s a need for targeted screening and prevention efforts, especially for common diseases like high blood pressure, cardiovascular disease, and stroke. The study also highlights the need for early detection of RMDs and related diseases, especially in younger women. Further research is needed to see if targeted interventions can reduce disease burden in this group.