Longitudinal Analysis of the Transition Between Multimorbidity and Mortality Patterns from a Syndemic Perspective

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Longitudinal analysis of multimorbidity (MM) in aging populations is crucial for effective medical care guidance.
• A holistic approach is needed to understand the complex interplay of conditions in older adults.

Purpose of the Study:

• To estimate transition probabilities between different multimorbidity (MM) patterns and mortality.
• To characterize the socioeconomic, health, behavioral, and functional dimensions of MM patterns from a syndemic viewpoint.

Main Methods:

• Latent class analysis and Markov chain models applied to 7,120 individuals aged 50+ from the Mexican Health and Aging Study.
• MM defined as the coexistence of two or more chronic diseases (CDs).
• Analysis included socioeconomic, health, behavioral, and functional indicators over 11 and 17 years of follow-up.

Main Results:

• Three latent MM classes identified: 'healthy,' 'multi-organic' (hypertension, arthritis, diabetes, lung disease, myocardial infarction), and 'sensitive-emotional, mental, neurological' (chronic pain, depression, cognitive impairment).
• Individuals in the 'multi-organic' class showed higher mortality risk at the first follow-up.
• At the second follow-up, the 'multi-organic' group transitioned towards the 'sensitive-emotional, mental, neurological' class.

Conclusions:

• Transition probabilities between MM classes and death vary significantly.
• Socioeconomic, behavioral, and functional dimensions influence the progression towards unfavorable outcomes in older adults.
• A syndemic perspective highlights the diverse trajectories of multimorbidity in aging populations.