Sarah L Malecki1,2, Spencer Van Mil2, Justin Graffi2, Elemi Breetvelt3, Maria Corral3,4, Erik Boot3,5,6,7, Eva W C Chow2,4, Marcos Sanches8, Amol A Verma9, Anne S Bassett10,11,12,13,14. 1. Internal Medicine Residency Program, University of Toronto, Toronto, ON, Canada. 2. Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. 3. The Dalglish Family 22q Clinic, University Health Network, Toronto, ON, Canada. 4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 5. Heeren Loo Zorggroep, Amersfoort, The Netherlands. 6. Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands. 7. Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands. 8. Biostatistical Consulting Service, Centre for Addiction and Mental Health, Toronto, ON, Canada. 9. Li Ka Shing Knowledge Institute & Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, ON, Canada. 10. Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. anne.bassett@utoronto.ca. 11. The Dalglish Family 22q Clinic, University Health Network, Toronto, ON, Canada. anne.bassett@utoronto.ca. 12. Department of Psychiatry, University of Toronto, Toronto, ON, Canada. anne.bassett@utoronto.ca. 13. Campbell Family Mental Health Research Institute, Toronto, ON, Canada. anne.bassett@utoronto.ca. 14. Division of Cardiology & Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. anne.bassett@utoronto.ca.
Abstract
PURPOSE: Multimorbidity is increasing in younger adults but is understudied in this population. We used 22q11.2 deletion syndrome (22q11.2DS) as a genetic model to investigate multimorbidity in young to middle-aged adults. METHODS: Using the Anatomical Therapeutic Chemical (ATC) Classification System and setting five or more concurrent prescription medications as a proxy for multimorbidity, we compared data on 264 adults with 22q11.2DS (median age 27.8, range 17.3-68.3 years) with that for a community-based Canadian general population sample (n = 25,287). We used logistic regression to examine possible predictors of multimorbidity in 22q11.2DS. RESULTS: Multimorbidity in 22q11.2DS in the 25-44 year age group (34.7%) was significantly more prevalent than in the general population, both for the same age group (2.9%, prevalence ratio [PR] = 11.9, 95% CI 8.4-17.1) and compared with those aged 45-64 years (16.4%, PR = 2.1, 95% CI 1.6-2.7). Neuropsychiatric and endocrinological medication classes predominated. Within 22q11.2DS, older age and psychotic illness, but not sex, major congenital heart disease, or intellectual disability, were significant predictors of multimorbidity. CONCLUSION: The results indicate that adults with 22q11.2DS have a significant burden of illness with levels of multimorbidity comparable with those of the general population several decades older. In younger adults with multimorbidity, certain disease patterns may help identify genetic disorders in "big data."
PURPOSE: Multimorbidity is increasing in younger adults but is understudied in this population. We used 22q11.2 deletion syndrome (22q11.2DS) as a genetic model to investigate multimorbidity in young to middle-aged adults. METHODS: Using the Anatomical Therapeutic Chemical (ATC) Classification System and setting five or more concurrent prescription medications as a proxy for multimorbidity, we compared data on 264 adults with 22q11.2DS (median age 27.8, range 17.3-68.3 years) with that for a community-based Canadian general population sample (n = 25,287). We used logistic regression to examine possible predictors of multimorbidity in 22q11.2DS. RESULTS: Multimorbidity in 22q11.2DS in the 25-44 year age group (34.7%) was significantly more prevalent than in the general population, both for the same age group (2.9%, prevalence ratio [PR] = 11.9, 95% CI 8.4-17.1) and compared with those aged 45-64 years (16.4%, PR = 2.1, 95% CI 1.6-2.7). Neuropsychiatric and endocrinological medication classes predominated. Within 22q11.2DS, older age and psychotic illness, but not sex, major congenital heart disease, or intellectual disability, were significant predictors of multimorbidity. CONCLUSION: The results indicate that adults with 22q11.2DS have a significant burden of illness with levels of multimorbidity comparable with those of the general population several decades older. In younger adults with multimorbidity, certain disease patterns may help identify genetic disorders in "big data."
Authors: Søren T Skou; Frances S Mair; Martin Fortin; Bruce Guthrie; Bruno P Nunes; J Jaime Miranda; Cynthia M Boyd; Sanghamitra Pati; Sally Mtenga; Susan M Smith Journal: Nat Rev Dis Primers Date: 2022-07-14 Impact factor: 65.038
Authors: Lily Van; Tracy Heung; Sarah L Malecki; Christian Fenn; Andrea Tyrer; Marcos Sanches; Eva W C Chow; Erik Boot; Maria Corral; Satya Dash; Susan R George; Anne S Bassett Journal: EClinicalMedicine Date: 2020-09-10
Authors: Ania M Fiksinski; Maude Schneider; Janneke Zinkstok; Danielle Baribeau; Samuel J R A Chawner; Jacob A S Vorstman Journal: Curr Psychiatry Rep Date: 2021-02-24 Impact factor: 5.285