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BMC Geriatr. 2017 Aug 18;17(1):186. doi: 10.1186/s12877-017-0586-1.

Latent class analysis of multimorbidity patterns and associated outcomes in Spanish older adults: a prospective cohort study.

Olaya B1,2,3, Moneta MV4,5,6, Caballero FF6,7,8, Tyrovolas S4,5,6, Bayes I4,5, Ayuso-Mateos JL6,7,8, Haro JM4,5,6.

Author information

1
Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain. beatriz.olaya@pssjd.org.
2
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. beatriz.olaya@pssjd.org.
3
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. beatriz.olaya@pssjd.org.
4
Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain.
5
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
6
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
7
Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
8
Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario de La Princesa, Madrid, Spain.

Abstract

BACKGROUND:

This study sought to identify multimorbidity patterns and determine the association between these latent classes with several outcomes, including health, functioning, disability, quality of life and use of services, at baseline and after 3 years of follow-up.

METHODS:

We analyzed data from a representative Spanish cohort of 3541 non-institutionalized people aged 50 years old and over. Measures were taken at baseline and after 3 years of follow-up. Latent Class Analysis (LCA) was conducted using eleven common chronic conditions. Generalized linear models were conducted to determine the adjusted association of multimorbidity latent classes with several outcomes.

RESULTS:

63.8% of participants were assigned to the "healthy" class, with minimum disease, 30% were classified under the "metabolic/stroke" class and 6% were assigned to the "cardiorespiratory/mental/arthritis" class. Significant cross-sectional associations were found between membership of both multimorbidity classes and poorer memory, quality of life, greater burden and more use of services. After 3 years of follow-up, the "metabolic/stroke" class was a significant predictor of lower levels of verbal fluency while the two multimorbidity classes predicted poor quality of life, problems in independent living, higher risk of hospitalization and greater use of health services.

CONCLUSIONS:

Common chronic conditions in older people cluster together in broad categories. These broad clusters are qualitatively distinct and are important predictors of several health and functioning outcomes. Future studies are needed to understand underlying mechanisms and common risk factors for patterns of multimorbidity and to propose more effective treatments.

KEYWORDS:

Clusters; Cognition; Disability; Follow-up; Multimorbidity; Older adults; Quality of life; Use of health services

PMID:
28821233
PMCID:
PMC5563011
DOI:
10.1186/s12877-017-0586-1
[Indexed for MEDLINE]
Free PMC Article

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