12-year evolution of multimorbidity patterns among older adults based on Hidden Markov Models
Roso-Llorach, Albert (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Vetrano, Davide L. (Stockholm Gerontology Research Center)
Trevisan, Caterina (University of Ferrara)
Fernández, Sergio (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Guisado-Clavero, Marina (Servicio de Salud de Madrid)
Carrasco-Ribelles, Lucia Amalía (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Fratiglioni, Laura (Stockholm Gerontology Research Center)
Violán, Concepció (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Calderón-Larrañaga, Amaia (Stockholm Gerontology Research Center)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Background: The evolution of multimorbidity patterns during aging is still an under-researched area. We lack evidence concerning the time spent by older adults within one same multimorbidity pattern, and their transitional probability across different patterns when further chronic diseases arise. The aim of this study is to fill this gap by exploring multimorbidity patterns across decades of age in older adults, and longitudinal dynamics among these patterns. Methods: Longitudinal study based on the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) on adults ≥60 years (N=3,363). Hidden Markov Models were applied to model the temporal evolution of both multimorbidity patterns and individuals' transitions over a 12-year follow-up. Findings: Within the study population (mean age 76. 1 years, 66. 6% female), 87. 2% had ≥2 chronic conditions at baseline. Four longitudinal multimorbidity patterns were identified for each decade. Individuals in all decades showed the shortest permanence time in an Unspecific pattern lacking any overrepresented diseases (range: 4. 6-10. 9 years), but the pattern with the longest permanence time varied by age. Sexagenarians remained longest in the Psychiatric-endocrine and sensorial pattern (15. 4 years); septuagenarians in the Neuro-vascular and skin-sensorial pattern (11. 0 years); and octogenarians and beyond in the Neuro-sensorial pattern (8. 9 years). Transition probabilities varied across decades, sexagenarians showing the highest levels of stability. Interpretation: Our findings highlight the dynamism and heterogeneity underlying multimorbidity by quantifying the varying permanence times and transition probabilities across patterns in different decades. With increasing age, older adults experience decreasing stability and progressively shorter permanence time within one same multimorbidity pattern.
Ayudas:	Instituto de Salud Carlos III PI19/00535
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Aging ; Hidden Markov Models ; Longitudinal population-based study ; Multimorbidity ; Older adults
Publicado en:	Aging (Albany NY), Vol. 14 (november 2022) , p. 9805-9817, ISSN 1945-4589

DOI: 10.18632/aging.204395
PMID: 36435509

13 p, 831.5 KB

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