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Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study

Author

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  • Inge Kirchberger
  • Christa Meisinger
  • Margit Heier
  • Anja-Kerstin Zimmermann
  • Barbara Thorand
  • Christine S Autenrieth
  • Annette Peters
  • Karl-Heinz Ladwig
  • Angela Döring

Abstract

Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65–94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity (≥2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19–3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26–3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms.

Suggested Citation

  • Inge Kirchberger & Christa Meisinger & Margit Heier & Anja-Kerstin Zimmermann & Barbara Thorand & Christine S Autenrieth & Annette Peters & Karl-Heinz Ladwig & Angela Döring, 2012. "Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-7, January.
    • Handle: RePEc:plo:pone00:0030556
    DOI: 10.1371/journal.pone.0030556
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    1. Ingmar Schäfer & Eike-Christin von Leitner & Gerhard Schön & Daniela Koller & Heike Hansen & Tina Kolonko & Hanna Kaduszkiewicz & Karl Wegscheider & Gerd Glaeske & Hendrik van den Bussche, 2010. "Multimorbidity Patterns in the Elderly: A New Approach of Disease Clustering Identifies Complex Interrelations between Chronic Conditions," PLOS ONE, Public Library of Science, vol. 5(12), pages 1-10, December.
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    3. Bomi Park & Hye Ah Lee & Hyesook Park, 2019. "Use of latent class analysis to identify multimorbidity patterns and associated factors in Korean adults aged 50 years and older," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-13, November.
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    5. Januse Nogueira de Carvalho & Marianna de Camargo Cancela & Dyego Leandro Bezerra de Souza, 2018. "Lifestyle factors and high body mass index are associated with different multimorbidity clusters in the Brazilian population," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-15, November.
    6. Helle Gybel Juul-Larsen & Janne Petersen & Ditte Maria Sivertsen & Ove Andersen, 2017. "Prevalence and overlap of Disease Management Program diseases in older hospitalized patients," European Journal of Ageing, Springer, vol. 14(3), pages 283-293, September.
    7. Januse Nogueira de Carvalho & Ângelo Giuseppe Roncalli & Marianna de Camargo Cancela & Dyego Leandro Bezerra de Souza, 2017. "Prevalence of multimorbidity in the Brazilian adult population according to socioeconomic and demographic characteristics," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-13, April.
    8. M Mofizul Islam & Jose M Valderas & Laurann Yen & Paresh Dawda & Tanisha Jowsey & Ian S McRae, 2014. "Multimorbidity and Comorbidity of Chronic Diseases among the Senior Australians: Prevalence and Patterns," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-11, January.
    9. Hossein Tabatabaei-Jafari & Jose A. Salinas-Perez & Mary Anne Furst & Nasser Bagheri & John Mendoza & David Burke & Peter McGeorge & Luis Salvador-Carulla, 2020. "Patterns of Service Provision in Older People’s Mental Health Care in Australia," IJERPH, MDPI, vol. 17(22), pages 1-18, November.
    10. Jesús Carretero-Bravo & Begoña Ramos-Fiol & Esther Ortega-Martín & Víctor Suárez-Lledó & Alejandro Salazar & Cristina O’Ferrall-González & María Dueñas & Juan Luis Peralta-Sáez & Juan Luis González-Ca, 2022. "Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(24), pages 1-17, December.
    11. Ignatios Ioakeim-Skoufa & Beatriz Poblador-Plou & Jonás Carmona-Pírez & Jesús Díez-Manglano & Rokas Navickas & Luis Andrés Gimeno-Feliu & Francisca González-Rubio & Elena Jureviciene & Laimis Dambraus, 2020. "Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    12. Fabian Kleinke & Peter Penndorf & Sabina Ulbricht & Marcus Dörr & Wolfgang Hoffmann & Neeltje van den Berg, 2020. "Levels of and determinants for physical activity and physical inactivity in a group of healthy elderly people in Germany: Baseline results of the MOVING-study," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    13. Arokiasamy, Perianayagam & Uttamacharya, Uttamacharya & Jain, Kshipra, 2013. "Multiple Chronic Diseases and Their Linkages with Functional health and Subjective Wellbeing among adults in the low-middle income countries: An Analysis of SAGE Wave1 Data, 2007/10," MPRA Paper 54914, University Library of Munich, Germany, revised Mar 2014.

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