Effect of Mental Health on Multimorbidity Onset and Outcomes

Sahar Ahmed , Centre d'Estudis Demogaphics
Aïda Solé-Auró, DemoSoc Research Group, Department of Political and Social Sciences, Universitat Pompeu Fabra
Iñaki Permanyer, Center for Demographic Studies

Multimorbidity—the co-occurrence of multiple chronic conditions—represents a major and growing public health challenge, with individuals developing disease earlier in life and accumulating conditions more rapidly. Mental health diagnoses have risen sharply in parallel, yet their contribution to multimorbidity progression and associated mortality remains insufficiently understood. Using population-based linked electronic health records from the HEALIN cohort in Catalonia (N = 1.55 million; follow-up: 2005–2022), we examine the impact of any mental health diagnosis on progression through morbidity stages: from healthy to single physical morbidity, multimorbidity, and complex multimorbidity. We also estimate mortality differentials across morbidity stages according to mental health status and assess variation by age and sex. We define multimorbidity as =2 chronic conditions in one organ system, and complex multimorbidity as =2 conditions in =2 organ systems. Individuals enter the cohort healthy and are followed until morbidity onset, death, or study end. Competing-risk time-to-event models evaluate transitions and mortality. We expect to find that a mental health diagnosis accelerates progression into physical morbidity and multimorbidity and substantially increases mortality risk within morbidity stages. Effects are anticipated to be more pronounced among younger adults and women. Findings will provide new evidence on how mental health shapes lifelong disease accumulation and survival. This work supports the urgent integration of mental health into chronic disease prevention and care pathways to reduce inequalities and improve patient outcomes.

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 Presented in Session P5. Health, Mortality, and Ageing 1