Patterns of multimorbidity trajectories and their correlates among Korean older adults

Abstract

Objective This study aims to identify distinct patterns of 10-year multimorbidity trajectory among Korean older adults and examine factors associated with the patterns. Methods Data were drawn from the six waves of the Korean Longitudinal Study of Ageing (KLoSA, 2006–2016). We examined trajectories of multimorbidity of 1,705 older adults aged 65 and older using Growth Mixture Modeling. Then, the identified patterns were used as dependent variables to examine the correlates of multimorbidity trajectories. Explanatory variables considered were sociodemographic, psychological, health behavioural and interpersonal factors at baseline. Results Four distinct patterns of multimorbidity trajectories were identified: ‘maintaining-low’ (59.4%), ‘chronically-high’ (7.5%), ‘moderately-increasing’ (26.0%) and ‘rapidly- increasing’ (7.1%). Gender, depressive symptoms, life satisfaction and frequency of contacts with others were associated with trajectory membership. Specifically, women were more likely to be in the ‘chronically-high’ group than any other groups. Compared to the ‘maintaining-low’ group, those with higher levels of depressive symptoms and lower levels of life satisfaction were more likely to belong to the ‘chronically-high’ group and ‘moderately-increasing’ group, respectively. Respondents who had less frequent meetings with others in close relationships were more likely to be in the ‘rapidly-increasing’ group than the ‘maintaining-low’ group. Discussion These findings are suggestive of distinct trajectories of multimorbidity across older adulthood, indicating that multimorbidity experiences might differ among older adults. Moreover, results suggest that there may be gender inequalities in multimorbidity trajectories, and that levels of psychological well-being and social engagement could be useful in identifying older adults who are at higher risk of worsening multimorbidity.

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

“…The majority of articles were conducted among adults and only three study included children 53–55. More than half (n=38/64) were cross-sectional and 26/64 used longitudinal data9 10 42 54 56–76 (table 2).…”

“…Educational attainment was the preferred measure of socioeconomic position (n=38/64), and 38 studies used multiple measures of socioeconomic position as exposures. The majority of studies (n=51/64) simply documented the presence of multimorbidity, and approximately one-third (n=13/64) additionally examined different patterns of multimorbidity9 40 41 45 47 53 55 67–70 72 75 77 78 (table 2).…”

Association between multimorbidity trajectories and incident disability among mid to older age adults: China Health and Retirement Longitudinal Study

“…In this model, the outcome variables were the factor scores of each multimorbidity pattern over the follow-up, and these variables were modeled using the censored normal distribution by setting the lowest score (-0.31) as the censored minimum and the highest score (2.68) as the censored maximum. Based on previous research on multimorbidity trajectories in Korean older adults [ 37 ], we hypothesized that there would be 2–6 distinct trajectories of multimorbidity. Model fitting proceeded iteratively by comparing models with a varying number of groups (2–6 groups) and shapes of trajectories (linear, quadratic, and cubic).…”

Association rules analysis on patterns of multimorbidity in adults: based on the National Health and Nutrition Examination Surveys database

“…Previous studies indicated that nearly 15% of American adults were suffered from multimorbidity, and worse still, the multimorbidity is occurring at more and more younger people 3 4. Multiple studies agreed that individuals with multimorbidity were associated with worse quality of life, increased functional decline, higher risk of psychological distress or depression and even increased risk of death 5 6. Additionally, the medical expenses of multimorbidity also caused substantial burden to the society 7.…”