Related Experiment Video
Updated: Jan 17, 2026
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Mapping multimorbidity cluster-specific intrinsic capacity impairment patterns and mortality risks in a
Fei Song1, Jagadish K Chhetri2, Mengjin Hu1
1Department of Cardiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Centre for Geriatric Diseases, Beijing, China.
Insights
Different chronic disease combinations impact intrinsic capacity (IC) uniquely. The respiratory cluster with IC impairment poses the highest mortality risk, highlighting the importance of personalized care for multimorbidity.
Area of Science:
- Gerontology
- Public Health
- Chronic Disease Management
Background:
- Chronic diseases often present as distinct clusters, each potentially affecting intrinsic capacity (IC) through unique pathological pathways.
- Understanding how these multimorbidity clusters impact specific IC domains and mortality risk is crucial for effective health management.
Purpose of the Study:
- To investigate the preferential impact of different multimorbidity clusters on specific intrinsic capacity (IC) domains.
- To determine which multimorbidity cluster poses the highest mortality risk in individuals with impaired IC.
Main Methods:
- Utilized data from the China Health and Retirement Longitudinal Study (CHARLS) with 4333 participants.
- Identified four multimorbidity clusters (arthritis-metabolic, stomach-arthritis, respiratory, metabolic-vascular) using latent class analysis (LCA).
- Assessed IC across six domains and analyzed associations with multimorbidity clusters and mortality risk using logistic and Cox regression.
Main Results:
- The respiratory cluster showed elevated risks of decline in cognitive, psychological, hearing, and vitality domains.
- The stomach-arthritis cluster was linked to impairments in psychological, visual, hearing, and vitality domains.
- Intrinsic capacity impairment in the respiratory cluster was significantly associated with increased mortality risk (HR = 1.74).
Conclusions:
- Significant heterogeneity exists in IC impairment patterns across multimorbidity clusters.
- IC impairment patterns are cluster-specific, and the risk of mortality associated with IC impairment is dependent on the specific multimorbidity cluster.
Background:
Growing evidence indicate that chronic diseases have distinct clusters, each potentially influencing intrinsic capacity (IC) through unique pathological pathways. This raises two critical questions: (1) How do different multimorbidity clusters preferentially impact specific IC domains? (2) Which multimorbidity cluster would have the highest risk of mortality in individuals with IC impairment?
Methods:
We used data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative cohort study in China. Multimorbidity was defined as the presence of two or more chronic conditions. IC impairment was assessed across six domains: cognition, locomotion, vitality, psychology, hearing and vision. We identified multimorbidity clusters using latent class analysis (LCA). Logistic regression was used to evaluate the association between identified multimorbidity clusters and domain specific IC decline, while Kaplan-Meier analysis and cox regression analysis were used to assess the mortality risk.
Results:
Among the 4333 participants with multimorbidity, 48.6% were male, with mean age of 59.5 years. LCA method identified four distinct multimorbidity clusters: arthritis-metabolic (24.8%), stomach-arthritis (29.4%), respiratory (16.5%), metabolic-vascular (29.4%) clusters. Multimorbidity cluster-specific patterns of IC impairment revealed markedly elevated risks of decline in the cognitive, psychological, hearing, and vitality domains within the respiratory cluster. Similarly, the stomach-arthritis cluster was associated with significantly higher risks of impairment in the psychological, visual, hearing, and vitality domains. In contrast, the arthritis-metabolic cluster demonstrated significantly increased risks specifically in the cognitive and psychological domains. Survival analysis revealed significant mortality differences across multimorbidity clusters (p < 0.001). After multivariate adjustment, intrinsic capacity impairment remained significantly associated with increased mortality in the respiratory cluster (HR = 1.74, 95%CI:1.06-2.87, p = 0.029), demonstrating pattern-dependent prognostic value of IC.
Conclusions:
Our findings revealed a significant heterogeneity in IC impairment patterns across different multimorbidity clusters, showing cluster-specific IC impairment and cluster-dependent risk of mortality according to IC impairment.
More Related Videos
06:52Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
04:13Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults
Published on: February 8, 2019
Related Concept Videos
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
01:15Drug Dosing: Geriatric Patients
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:26Aging
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
01:18Factors Affecting Illness
For instance, risk factors are connected to illness,...