A Health Profile of Senior-Aged Women Veterans: A Latent Class Analysis of Condition Clusters

Abstract

Background and ObjectivesThis study characterizes the multiple morbidities experienced by senior-aged women Veterans so that the Veterans Health Administration (VHA) and other health care systems may be better prepared to meet the health care needs of this growing cohort.Research Design and MethodsUsing the VHA’s Corporate Data Warehouse, we conducted a retrospective observational study of the 38,597 female veteran patients who were at least 65 years old and received care in the VHA during 2013 and 2014. We use a latent class analysis model to cluster diagnoses associated with inpatient and outpatient events over the years.ResultsThe senior-aged women Veterans are characterized by six major classes of disease clusters. We defined these classes as: Healthy (16.24% of the cohort); Ophthalmological Disorders (13.84%); Musculoskeletal Disorders (14.22%); At Risk for Cardiovascular Disease (37.53%); Diabetic with Comorbidities (9.05%); and Multimorbid (9.12%). The patterns and prevalence of these condition classes vary by race, age, and marital status.Discussion and ImplicationsEach of the six clusters can be used to develop clinical practice guidelines that are appropriate for senior-aged women Veterans. Consistent with past literature, the most common conditions in this cohort are hypertension and hyperlipidemia; together they form the most common class, “At Risk of Cardiovascular Disease (CVD)”. Results also show evidence of race-related disparities, with Blacks being more likely to be in the highest risk classes. Also, members of the cohort who are currently married having improved chances of being in the healthy class. And finally, we see a “healthy survivor” effect with the oldest women in our cohort having low overall rates of disease.

<p>Patterns of Multimorbidity and Differences in Healthcare Utilization and Complexity Among Acutely Hospitalized Medical Patients (≥65 Years) – A Latent Class Approach</p>

“…The multimorbid patterns: "Metabolic and cardiovascular disorders"; "Cardiovascular disorders"; "Minimal chronic conditions"; "Neuropsychiatric and functional disorders"; and for women "Complex multimorbidity" were also found in other studies. 19,21,42,[44][45][46] We found six patterns that showed only minimal differences between sexes, and two patterns showed substantial differences in Figure 3 Age-adjusted odds ratios for differences in healthcare complexity the last year before an acute hospitalization between patients in the eight multimorbid patterns. disease patterns and was therefore labelled differently for women and men.…”

“…41 We did not find a pattern that we could classify as "healthy" as other studies have. 21,[42][43][44][45] However, the population in our study was defined as acutely hospitalized older medical patients and therefore likely represents a more vulnerable group. The majority of our sample (23% for women and 25% for men) was classified into the "Minimal chronic conditions" pattern for both sexes and also had the lowest expected number of chronic conditions (2 for women and 2 for men).…”

“…Only a handful of studies have investigated multimorbid patterns among older people using LCA and have in general found fewer multimorbid patterns than in the present study. 19,21,42,[44][45][46][47] This might be caused by differences in population; study sample; and/or items. Despite these differences, there are however some similarities in the multimorbid patterns.…”

Clinical Pattern of Preoperative Positron Emission Tomography/Computed Tomography (PET/CT) Can Predict the Aggressive Behavior of Resected Solid Pseudopapillary Neoplasm of the Pancreas

“…Advanced age amplifies the impact of certain conditions, such as hypertension, diabetes, and certain tumors. Some studies have suggested that cellular/physical degeneration and immune-related deterioration can be the cause of age-related disease conditions [ 30 , 31 , 32 ].…”

Uptake of Video-Assisted Thoracoscopic Lung Resections Within the Veterans Affairs for Known or Suspected Lung Cancer

“…Data are aggregated from individual hospital VistA systems into the VA CDW, where it is modeled and prepared for use . The VA National Data Services and other data stewards regulate the right to use the data.…”