A Latent Class Analysis of Multimorbidity and the Relationship to Socio-Demographic Factors and Health-Related Quality of Life. A National Population-Based Study of 162,283 Danish Adults

多重疾病及其与社会人口因素和健康相关生活质量关系的潜在类别分析:一项基于162,283名丹麦成年人的全国性人口研究

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Abstract

OBJECTIVES: To identify patterns of multimorbidity in the general population and examine how these patterns are related to socio-demographic factors and health-related quality of life. STUDY DESIGN AND SETTING: We used latent class analysis to identify subgroups with statistically distinct and clinically meaningful disease patterns in a nationally representative sample of Danish adults (N = 162,283) aged 16+ years. The analysis was based on 15 chronic diseases. RESULTS: Seven classes with different disease patterns were identified: a class with no or only a single chronic condition (59% of the population) labeled "1) Relatively Healthy" and six classes with a very high prevalence of multimorbidity labeled; "2) Hypertension" (14%); "3) Musculoskeletal Disorders" (10%); "4) Headache-Mental Disorders" (7%); "5) Asthma-Allergy" (6%); "6) Complex Cardiometabolic Disorders" (3%); and "7) Complex Respiratory Disorders" (2%). Female gender was associated with an increased likelihood of belonging to any of the six multimorbidity classes except for class 2 (Hypertension). Low educational attainment predicted membership of all of the multimorbidity classes except for class 5 (Asthma-Allergy). Marked differences in health-related quality of life between the seven latent classes were found. Poor health-related quality of life was highly associated with membership of class 6 (Complex Cardiometabolic Disorders) and class 7 (Complex Respiratory Disorders). Despite different disease patterns, these two classes had nearly identical profiles in relation to health-related quality of life. CONCLUSION: The results clearly support that diseases tend to compound and interact, which suggests that a differentiated public health and treatment approach towards multimorbidity is needed.

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