Multimorbidity patterns in the elderly: a prospective cohort study with cluster analysis

Area of Science:

• Gerontology
• Public Health
• Clinical Medicine

Background:

• Multimorbidity, the coexistence of multiple chronic diseases, lacks a universal definition.
• Variability of multimorbidity patterns over time is understudied.
• Focus on primary care patients aged 65+.

Purpose of the Study:

• Identify multimorbidity patterns in older adults.
• Analyze the stability of these patterns over a 6-year period.
• Stratify analysis by sex and age group.

Main Methods:

• Cohort study with yearly cross-sectional analysis of electronic health records.
• International Classification of Primary Care, second edition diagnoses used.
• Multiple correspondence analysis and k-means clustering for pattern identification.

Main Results:

• 190,108 patients with multimorbidity analyzed.
• Six distinct multimorbidity patterns identified per group (nonspecific and five specific).
• Specific patterns included Musculoskeletal, Endocrine-metabolic, Digestive/Digestive-respiratory, Neurological, and Cardiovascular.
• At least 42.5% of patients remained in their pattern over 6 years.

Conclusions:

• Six multimorbidity patterns were identified, characterized by organic system specificity.
• Patterns demonstrated stability over the study period.
• Findings support improved clinical management for specific patient subgroups.