Do replicable profiles of multimorbidity exist? Systematic review and synthesis

Area of Science:

• Health Sciences
• Biomedical Research
• Clinical Epidemiology

Background:

• Multimorbidity, the co-occurrence of multiple chronic conditions, poses a significant challenge in healthcare.
• Identifying consistent patterns or profiles of multimorbidity is crucial for effective clinical management and research.

Purpose of the Study:

• To systematically review and synthesize existing literature on multimorbidity profiling.
• To identify replicable and clinically meaningful groupings of co-occurring diseases.

Main Methods:

• Systematic search of six electronic databases (Medline, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science).
• Synthesis of identified multimorbidity profiles using multidimensional scaling, stratified by statistical analysis type.
• Analysis of 98 separate profiling analyses from 51 included studies.

Main Results:

• A total of 407 multimorbidity profiles were identified using methods like factor analysis, cluster analysis, and latent class analysis.
• Mental health conditions and cardio-metabolic conditions emerged as the most consistently replicable multimorbidity profiles across different statistical approaches.
• Partially replicable profiles included COPD with asthma, falls/fractures with sensory deficits, and Parkinson's disease with cognitive decline.

Conclusions:

• Mental health and cardio-metabolic conditions represent key, consistently observed multimorbidity profiles.
• Further research is needed to elucidate the etiology and evolution of these disease groupings.
• Recommendations are proposed to enhance the reporting standards of multimorbidity profiling studies.