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Peer-reviewedCC BY 4.0PLOS One

Longitudinal physical-mental multimorbidity trajectories by sociodemographic factors: a cohort study using electronic health records in Scotland (2000–2021)

  • Thu Nguyen1
  • Katherine Keenan2
  • Colin McCowan3
  • Michail Papathomas4
  • Areti Manataki
4 affiliations
  1. 1School of Computer Science, University of St Andrews, St Andrews, United Kingdom
  2. 2School of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom
  3. 3Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, United Kingdom
  4. 4School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom
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Abstract

Multimorbidity, the co-occurrence of two or more chronic conditions, is a pressing global health challenge. However, research capturing the dynamic, longitudinal nature of health trajectories, particularly the intersection of physical and mental domains, remains scarce compared to traditional cross-sectional “snapshots.” Leveraging up to 21 years of electronic health records data from 858,789 Scottish patients in the University of Dundee Health Informatics Centre, we used multistate modelling to explore how individuals transition from a disease-free baseline into multimorbidity, evaluating how age, sex, and socioeconomic status shape these pathways. Overall transition estimates were driven by the younger demographic of our baseline disease-free cohort. The findings highlight the critical role of severe, hospital-contacting mental health conditions in driving early-onset multimorbidity, particularly in young men and socioeconomically disadvantaged groups. These findings underscore the urgent need to prioritise integrated physical-mental care and address upstream structural determinants of health. This temporal approach identifies high-risk populations for targeted early interventions and informs policy initiatives aimed at reducing health disparities.

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Cite

BibTeXRIS
BibTeX
@article{nguyen2026longitudinal,
  title = {{Longitudinal physical-mental multimorbidity trajectories by sociodemographic factors: a cohort study using electronic health records in Scotland (2000–2021)}},
  author = {Thu Nguyen and Katherine Keenan and Colin McCowan and Michail Papathomas and Areti Manataki},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0359871},
  url = {https://doi.org/10.1371/journal.pone.0359871},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Longitudinal physical-mental multimorbidity trajectories by sociodemographic factors: a cohort study using electronic health records in Scotland (2000–2021)
AU  - Thu Nguyen
AU  - Katherine Keenan
AU  - Colin McCowan
AU  - Michail Papathomas
AU  - Areti Manataki
PY  - 2026
DA  - 2026/10/15
JO  - PLOS One
DO  - 10.1371/journal.pone.0359871
UR  - https://doi.org/10.1371/journal.pone.0359871
AB  - Multimorbidity, the co-occurrence of two or more chronic conditions, is a pressing global health challenge. However, research capturing the dynamic, longitudinal nature of health trajectories, particularly the intersection of physical and mental domains, remains scarce compared to traditional cross-sectional “snapshots.” Leveraging up to 21 years of electronic health records data from 858,789 Scottish patients in the University of Dundee Health Informatics Centre, we used multistate modelling to explore how individuals transition from a disease-free baseline into multimorbidity, evaluating how age, sex, and socioeconomic status shape these pathways. Overall transition estimates were driven by the younger demographic of our baseline disease-free cohort. The findings highlight the critical role of severe, hospital-contacting mental health conditions in driving early-onset multimorbidity, particularly in young men and socioeconomically disadvantaged groups. These findings underscore the urgent need to prioritise integrated physical-mental care and address upstream structural determinants of health. This temporal approach identifies high-risk populations for targeted early interventions and informs policy initiatives aimed at reducing health disparities.
SN  - 1932-6203
ER  -