Multimorbidity patterns in older persons and their association with self-reported quality of life and limitations in activities of daily living

Archives of Gerontology and Geriatrics, vol. 115, pp. 105134

Abstract

BACKGROUND: As populations age, multimorbidity (the presence of two or more chronic morbidities) is increasingly more common. These evolving demographics demand further research into the identification of morbidity patterns in different settings as well as the longitudinal effects of these patterns. METHODS: Prospectively collected data on 12,755 older persons aged 65+ years were derived from The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS, www.topics-mds.eu). Latent class analyses were performed to identify unobserved relationship patterns between morbidities in older persons. Using linear mixed models, the average difference in health-related quality of life (EQ-5D) and general quality of life scores (Cantril's Self Anchoring Ladder) as well as limitations in Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL) were examined over a 12-month period. RESULTS: Five multimorbidity patterns were identified: sensory (n = 3882), cardio-metabolic (n = 2627), mental health (n = 920), osteo-articular (n = 4486), and system decline (n = 840). Relative to older persons in the sensory group, multimorbidity patterns did not have a strong effect on health-related quality of life, general quality of life or ADL/IADLs over a one-year period. CONCLUSIONS: The observed multimorbidity patterns are similar to others based on different methodologies and study populations. When examining the effect of such patterns on quality of life, the EQ-5D and Cantril's Ladder may be insufficient outcome measures. Further investigations into the prognostic value of morbidity patterns would be of benefit.

Authors 9

1. Jennifer E. Lutomski corresponding

   Radboud University Nijmegen · Radboud University Medical Center

   Affiliation as printed

   Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands

   Radboud Biobank, Radboud University Medical Center, Nijmegen, Netherlands

2. Trynke Hoekstra

   Amsterdam Public Health · Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands

   Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Netherlands

3. Marjan van den Akker

   Goethe University Frankfurt · Maastricht University Medical Centre · Maastricht University · Care and Public Health Research Institute · UCLouvain · KU Leuven

   Affiliation as printed

   Goethe University Frankfurt, Institute of General Practice, Frankfurt am Main, Germany; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, the Netherlands; Department of General Practice, Catholic University of Leuven, Belgium

   Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Netherlands

   Department of General Practice, Catholic University of Leuven, Belgium

   Goethe University Frankfurt, Institute of General Practice, Frankfurt am Main, Germany

4. Jeanet W. Blom Aachen Department of Public Health and Primary Care

   Leiden University Medical Center

   Affiliation as printed

   Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands

   Department of Public Health and Primary Care, Leiden University Medical Center, Netherlands

5. Amaia Calderón‐Larrañaga

   Stockholm University · Instituto de Salud Carlos III · Karolinska Institutet · Instituto de Investigación Sanitaria Aragón · Instituto Aragonés de Ciencias de la Salud · University of Brescia

   Affiliation as printed

   EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, REDISSEC-ISCIII, Spain; Department of Clinical and Experimental Sciences, University of Brescia, Italy

   Aging Research Center, NVS Department - Karolinska Institutet, Stockholm University, Stockholm, Sweden

   EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, REDISSEC-ISCIII, Spain

6. Alessandra Marengoni

   Stockholm University · Karolinska Institutet · University of Brescia

   Affiliation as printed

   Department of Clinical and Experimental Sciences, University of Brescia, Italy; Aging Research Center, NVS Department - Karolinska Institutet, Stockholm University, Stockholm, Sweden

   Aging Research Center, NVS Department - Karolinska Institutet, Stockholm University, Stockholm, Sweden

   Department of Clinical and Experimental Sciences, University of Brescia, Italy

7. Alexandra Prados‐Torres

   Instituto de Salud Carlos III · Instituto de Investigación Sanitaria Aragón

   Affiliation as printed

   EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, REDISSEC-ISCIII, Spain

8. Marcel G.M. Olde-Rikkert

   Radboud University Medical Center

   Affiliation as printed

   Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands

   Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands

9. René J. F. Melis

   Radboud University Medical Center

   Affiliation as printed

   Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands

   Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands