B3916 - Physical and mental health multimorbidity across the lifespan LIfespaN multimorbidity research Collaborative LINC - 19/11/2021

B number: 
Principal applicant name: 
Marianne van den Bree | Cardiff University (United Kingdom)
Prof Golam Khandaker, Prof Nic Timpson, Prof Peter Holmans, Prof James Walters, Prof Michael Owen, Prof George Kirov, Prof John MacLeod, Prof Mark Mon-Williams, Prof Sarah Finer, Dr Andres Ingason
Title of project: 
Physical and mental health multimorbidity across the lifespan (LIfespaN multimorbidity research Collaborative: LINC).
Proposal summary: 

Multimorbidity (MM) happens when two or more different diseases are present at the same time in an individual. This is
common between physical and psychiatric diseases with almost half of people with a psychiatric disease also having a
physical disease. As well as about a third of people with a physical disease also having a psychiatric disease. These
patients have worse quality of life than those with a single disease, they often struggle to get the best care and are at risk of
living less long. A common and serious type of MM is between internalizing diseases (depression and anxiety) and
cardiovascular disease (ICV-MM). Still, very little is understood as to how ICV-MM develops and why it happens. We do
know however that both internalizing disease and cardiovascular risk (e.g., obesity, cholesterol) tend to begin before
To really understand how ICV-MM risk develops, we need large studies of people of all ages whose health has been followed
over time. Studies of children are crucial because they can tell us about early risks for development of ICV-MM later in life.
This is important for developing better plans to prevent at-risk children developing ICV-MM.
We know that genes influence risk of both internalizing and cardiovascular disease and that some people are at high
genetic risk. We also know that certain conditions that start early in life (neurodevelopmental conditions) such as
intellectual disability, autism and ADHD increase risk of developing ICV MM later. Children's environments can also
increase this risk, for example, stressful experiences such as poverty and physical or sexual abuse. But how exactly genes,
neurodevelopmental conditions and early environmental risks influence the development of ICV-MM over the lifespan is still
not understood.
Certain groups are known to be at increased risk of ICV-MM, such as people of South Asian heritage and women, but we
don't know why this is. Better understanding of how ICV-MM develops in different groups in society will help doctors give
patients care that is matched to their specific needs. It will also help doctors, governments and schools prevent ICV-MM in
at-risk children in ways that work best for them.
To really understand the complexities of ICV-MM development, a team of researchers with a wide range of expertise is
needed who together understand physical and psychiatric diseases as well as how genetics, neurodevelopmental
conditions and the environments people live in influence them throughout their lives.
Our LIfespaN multimorbidity research Collaborative (LINC) combines wide-ranging medical and research expertise in
physical and psychiatric diseases. We have brought together five very large studies in which the health of many people has
been followed over time. Rich medical data is available, including from medical records. Genetic information is also
available for these people. Other important information has also been collected such as on people's living environments,
life events and lifestyles.
These studies follow the health over time of children, adolescents and adults. We can therefore study how internalizing and
cardiovascular disease happen together in adulthood. Importantly we can then also study early risk factors in the children
before they develop these conditions. Because our child and adult samples differ in ethnicity and economic situation, we
can also study how the development of ICV-MM differs for different groups in society. Finally, because we have genetic
data, we can study how genes influence ICV-MM development in people at risk.
Our study will help us understand how ICV-MM develops and which circumstances influence this. What we learn will be
important for the prevention of ICV-MM in children who are at risk because of genetics, their sex, or ethnic or economic reasons. We will work with patients, doctors and charities to develop specific health advice in order to reduce ICV-MM in at
risk groups in the future.

Impact of research: 
Potentially high, informing policy, clinical practice
Date proposal received: 
Thursday, 21 October, 2021
Date proposal approved: 
Tuesday, 26 October, 2021
Epidemiology, Mental health, Statistical methods, Cardiovascular