Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study

Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the populatio...

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Published in:	PloS one Vol. 7; no. 1; p. e30556
Main Authors:	Kirchberger, Inge, Meisinger, Christa, Heier, Margit, Zimmermann, Anja-Kerstin, Thorand, Barbara, Autenrieth, Christine S., Peters, Annette, Ladwig, Karl-Heinz, Döring, Angela
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 23.01.2012 Public Library of Science (PLoS)
Subjects:	Age Aged Aged, 80 and over Analysis Anxiety Biology Cancer Cardiovascular Diseases - epidemiology Chronic conditions Chronic illnesses Comorbidity Comorbidity - trends Confidence intervals Data processing Diabetes mellitus Diabetes Mellitus - epidemiology Eye Eye diseases Eye Diseases - epidemiology Factor analysis Female Gastrointestinal diseases Geriatrics Germany - epidemiology Humans Hypertension Hypertension - epidemiology Liver Liver diseases Lung diseases Macular degeneration Male Medicine Mental Disorders - epidemiology Metabolic disorders Multimorbidity Nervous system diseases Neurological diseases Older people Population Prevalence Regression analysis Regression models Statistical analysis Studies Surveys Germany
ISSN:	1932-6203, 1932-6203
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Abstract	Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65-94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity (≥2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19-3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26-3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms.
AbstractList	Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65-94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity ([greater than or equal to]2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19-3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26-3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms. Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65–94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity (≥2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19–3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26–3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms. Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65-94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity (≥2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19-3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26-3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms.Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65-94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity (≥2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19-3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26-3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms.
Audience	Academic
Author	Döring, Angela Meisinger, Christa Autenrieth, Christine S. Kirchberger, Inge Zimmermann, Anja-Kerstin Ladwig, Karl-Heinz Peters, Annette Thorand, Barbara Heier, Margit
AuthorAffiliation	3 Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany Marienhospital Herne - University of Bochum, Germany 2 MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany 1 Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
AuthorAffiliation_xml	– name: 1 Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany – name: Marienhospital Herne - University of Bochum, Germany – name: 3 Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany – name: 2 MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
Author_xml	– sequence: 1 givenname: Inge surname: Kirchberger fullname: Kirchberger, Inge – sequence: 2 givenname: Christa surname: Meisinger fullname: Meisinger, Christa – sequence: 3 givenname: Margit surname: Heier fullname: Heier, Margit – sequence: 4 givenname: Anja-Kerstin surname: Zimmermann fullname: Zimmermann, Anja-Kerstin – sequence: 5 givenname: Barbara surname: Thorand fullname: Thorand, Barbara – sequence: 6 givenname: Christine S. surname: Autenrieth fullname: Autenrieth, Christine S. – sequence: 7 givenname: Annette surname: Peters fullname: Peters, Annette – sequence: 8 givenname: Karl-Heinz surname: Ladwig fullname: Ladwig, Karl-Heinz – sequence: 9 givenname: Angela surname: Döring fullname: Döring, Angela
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/22291986$$D View this record in MEDLINE/PubMed
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Copyright	COPYRIGHT 2012 Public Library of Science 2012 Kirchberger et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Kirchberger et al. 2012
Copyright_xml	– notice: COPYRIGHT 2012 Public Library of Science – notice: 2012 Kirchberger et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Kirchberger et al. 2012
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Conceived and designed the experiments: CM MH BT CSA AP K-HL AD. Performed the experiments: CM MH BT CSA AP K-HL AD. Analyzed the data: IK A-KZ. Wrote the paper: IK.
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Snippet	Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore...
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SubjectTerms	Age Aged Aged, 80 and over Analysis Anxiety Biology Cancer Cardiovascular Diseases - epidemiology Chronic conditions Chronic illnesses Comorbidity Comorbidity - trends Confidence intervals Data processing Diabetes mellitus Diabetes Mellitus - epidemiology Eye Eye diseases Eye Diseases - epidemiology Factor analysis Female Gastrointestinal diseases Geriatrics Germany - epidemiology Humans Hypertension Hypertension - epidemiology Liver Liver diseases Lung diseases Macular degeneration Male Medicine Mental Disorders - epidemiology Metabolic disorders Multimorbidity Nervous system diseases Neurological diseases Older people Population Prevalence Regression analysis Regression models Statistical analysis Studies Surveys
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Title	Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study
URI	https://www.ncbi.nlm.nih.gov/pubmed/22291986 https://www.proquest.com/docview/1323411488 https://www.proquest.com/docview/919227824 https://pubmed.ncbi.nlm.nih.gov/PMC3264590 https://doaj.org/article/ca9b07f332d14e38b9010e1c3c7d5968 http://dx.doi.org/10.1371/journal.pone.0030556
Volume	7
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