Cluster analysis for the overall health status of elderly, multimorbid patients with diabetes

Yan, Bing; Yuan, Lei; Liu, Ji; Wang, Zezhong; Chen, Lifu; Sun, Junying; Liu, Lijuan

doi:10.3389/fpubh.2023.1031457

Cited by 1 publication

(1 citation statement)

References 54 publications

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“…Using a similar definition of multimorbidity, a previous study in the United States found the prevalence of multimorbidity in diabetes patients to be 92% ( Kerr et al, 2007 ), which is similar to the present findings. We also found the prevalence of multimorbidity in diabetes patients to be slightly higher in women than in men, which is consistent with a previous finding ( Bing et al, 2023 ). A potential explanation for the higher prevalence in women is the structural placement of women in society ( Arber and Cooper, 1999 ).…”

Section: Discussionsupporting

confidence: 93%

The effect of multimorbidity patterns on physical and cognitive function in diabetes patients: a longitudinal cohort of middle-aged and older adults in China

Zhou,

Qin,

et al. 2024

Front. Aging Neurosci.

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BackgroundThe prevalence of diabetes has increased rapidly, and comorbid chronic conditions are common among diabetes patients. However, little is known about the pattern of multimorbidity in diabetes patients and the effect on physical and cognitive function. This study aimed to assess the disease clusters and patterns of multimorbidity in diabetes patients using a novel latent class analysis (LCA) approach in middle-aged and older adults and explore the association between different clusters of multimorbidity in diabetes and the effect on physical and cognitive function.MethodsThis national observational study included 1,985 diabetes patients from the four waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2011 to 2018. Thirteen chronic diseases were used in latent class analysis to identify the patterns of multimorbidity in diabetes, which span the cardiovascular, physical, psychological, and metabolic systems. Cognitive function is assessed via a structured questionnaire in three domains: memory, executive function, and orientation. We combined activities of daily living (ADL) with instrumental activities of daily living (IADL) to measure physical function. Linear mixed models and negative binomial regression models were used to analyze the association between patterns of multimorbidity in diabetes and the effect on cognitive function and disability, respectively.ResultsA sample of 1,985 diabetic patients was identified, of which 1,889 (95.2%) had multimorbidity; their average age was 60.6 years (standard deviation (SD) = 9.5), and 53.1% were women. Three clusters were identified: “cardio-metabolic” (n = 972, 51.5%), “mental-dyslipidemia-arthritis” (n = 584, 30.9%), and “multisystem morbidity” (n = 333, 17.6%). Compared with diabetes alone, the “multisystem morbidity” class had an increased association with global cognitive decline. All patterns of multimorbidity were associated with an increased risk of memory decline and disability; however, the “multisystem morbidity” group also had the strongest association and presented a higher ADL-IADL disability (ratio = 4.22, 95% CI = 2.52, 7.08) and decline in memory Z scores (β = −0.322, 95% CI = −0.550, −0.095, p = 0.0058).ConclusionSignificant longitudinal associations between different patterns of multimorbidity in diabetes patients and memory decline and disability were observed in this study. Future studies are needed to understand the underlying mechanisms and common risk factors for multimorbidity in diabetes patients and to propose treatments that are more effective.

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Section: Discussionsupporting

confidence: 93%