Latent Class Analysis of Multimorbidity Patterns and Associated Functional Outcomes Amongst Elderly Aged 60 Years and Above.

Abstract

Aim: Multiple comorbidities are common amongst the elderly due to shared underlying factors. We used latent class analysis (LCA) to explore the of multimorbidities amongst the elderly and their association with self-rating of health, life satisfaction, limitations in daily activities and depressive symptoms.

Methods: We utilised a subset of nationally representative survey data from the Longitudinal Aging Survey of India 2017-2018 covering elderly >= 60 years of age. LCA was used to examine patterns of 11 chronic morbidities. Classes were compared across socio-demographic and behavioural characteristics. Various model fit statistics (Akaike, Bayesian and sample size adjusted Bayesian information criteria, likelihood ratio tests and entropy) and the meaningfulness of the classes were used to select the number of latent classes.

Results: Four distinct latent classes were identified: 'Hypertension/Lung/Bone/Others', 'Cardio-metabolic', 'Hypertension-Diabetes' and the 'Healthy class'. There were significant differences between classes on socio-demographics (age, sex, residence, education, wealth quintile) and behaviours (tobacco, alcohol, physical activity, yoga). 'Hypertension/Lung/Bone/Others' class was significantly associated with limitations in ADLs, limitations in IADLs and depressive symptoms compared to the 'healthy class'. 'Cardio-metabolic' class had significantly higher rates of hospital admission in the last 12 months.

Conclusions: Elderly could be grouped into four distinct classes based on their multimorbidity status. The single-disease paradigm does not fit the approach for caring for patients with multimorbid conditions. Care of multimorbid elderly individuals needs an integrated and continuity of care approach.