Use of latent class analysis to identify multimorbidity patterns and associated factors in Korean adults aged 50 years and older

Abstract

AbstractIntroductionMultimorbidity associated with significant disease and economic burdens is common among the aged. We identified chronic disease multimorbidity patterns in Koreans 50 years of age or older, and explored whether such patterns were associated with particular sociodemographic factors and health-related quality-of-life.MethodsThe multimorbidity patterns of 10 chronic diseases (hypertension, dyslipidemia, stroke, osteoarthritis, tuberculosis, asthma, allergic rhinitis, depression, diabetes mellitus, and thyroid disease) were identified via latent class analysis of data on 8,370 Korean adults aged 50+ years who participated in the sixth Korean National Health and Nutrition Examination Survey (2013-2015). The associations between multimorbidity patterns, and sociodemographic factors and health-related quality of life, were subjected to regression analysis.ResultsThree patterns of multimorbidity were identified: 1) a relatively healthy group (60.4% of the population); 2) a ‘cardiometabolic conditions’ group (27.8%); and, 3) an ‘arthritis, asthma, allergic rhinitis, depression, and thyroid disease’ group (11.8%). The female (compared to male) gender was associated with an increased likelihood of membership of thecardiometabolic conditionsgroup (odds ratio [OR]=1.32, 95% confidence interval [CI]=1.15-1.51) and (to a much greater extent) thearthritis, asthma, allergy, depression, and thyroid diseasegroup (OR=4.32, 95% CI=3.30-5.66). Low socioeconomic status was associated with membership of the two multimorbidity classes. Membership of thearthritis, asthma, allergy, depression, and thyroid diseasegroup was associated with a significantly poorer health-related quality-of-life than was membership of the other two groups.ConclusionThe co-occurrence of chronic diseases was not attributable to chance. Multimorbidity patterns were associated with sociodemographic factors and quality-of-life. Our results suggest that targeted, integrated public health and clinical strategies dealing with chronic diseases should be based on an understanding of multimorbidity patterns; this would improve the quality-of-life of vulnerable multimorbid adults.