Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;77(12):770-776.
doi: 10.1136/jech-2023-220696. Epub 2023 Aug 23.

Clustering by multiple long-term conditions and social care needs: a cross-sectional study among 10 026 older adults in England

Nusrat Khan  1 , Christos V Chalitsios  1 , Yvonne Nartey  1 , Glenn Simpson  1 , Francesco Zaccardi  2 , Miriam Santer  1 , Paul J Roderick  1 , Beth Stuart  3 , Andrew J Farmer  4 , Hajira Dambha-Miller  5
Affiliations

Clustering by multiple long-term conditions and social care needs: a cross-sectional study among 10 026 older adults in England

Nusrat Khan et al. J Epidemiol Community Health. 2023 Dec.

Erratum in

Abstract

BACKGROUND : People with multiple long-term conditions (MLTC) face health and social care challenges. This study aimed to classify people by MLTC and social care needs (SCN) into distinct clusters and quantify the association between derived clusters and care outcomes. METHODS : A cross-sectional study was conducted using the English Longitudinal Study of Ageing, including people with up to 10 MLTC. Self-reported SCN was assessed through 13 measures of difficulty with activities of daily living, 10 measures of mobility difficulties and whether health status was limiting earning capability. Latent class analysis was performed to identify clusters. Multivariable logistic regression quantified associations between derived MLTC/SCN clusters, all-cause mortality and nursing home admission. RESULTS: Our study included 9171 people at baseline with a mean age of 66.3 years; 44.5% were men. Nearly 70.8% had two or more MLTC, the most frequent being hypertension, arthritis and cardiovascular disease. We identified five distinct clusters classified as high SCN/MLTC through to low SCN/MLTC clusters. The high SCN/MLTC included mainly women aged 70-79 years who were white and educated to the upper secondary level. This cluster was significantly associated with higher nursing home admission (OR=8.71; 95% CI: 4.22 to 18). We found no association between clusters and all-cause mortality. CONCLUSIONS: We have highlighted those at risk of worse care outcomes, including nursing home admission. Distinct clusters of individuals with shared sociodemographic characteristics can help identify at-risk individuals with MLTC and SCN at primary care level.

Keywords: CLUSTER ANALYSIS; EPIDEMIOLOGY; GERIATRICS; PUBLIC HEALTH.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Item response probabilities of multiple long-term conditions and social care needs clusters.
Figure 2
Figure 2
ORs (with 95% CI) of the association between clusters of multiple long-term conditions/social care needs and the outcomes of interest.
See this image and copyright information in PMC

References

    1. Sciences A of M . Multimorbidity: a priority for global health research. 2018.
    1. Kingston A, Robinson L, Booth H, et al. . Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age Ageing 2018;47:374–80. 10.1093/ageing/afx201 - DOI - PMC - PubMed
    1. Nunes BP, Flores TR, Mielke GI, et al. . Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr 2016;67:130–8. 10.1016/j.archger.2016.07.008 - DOI - PubMed
    1. Coste J, Valderas JM, Carcaillon-Bentata L. Estimating and characterizing the burden of multimorbidity in the community: a comprehensive multistep analysis of two large nationwide representative surveys in France. PLOS Med 2021;18:e1003584. 10.1371/journal.pmed.1003584 - DOI - PMC - PubMed
    1. Gardener EA, Huppert FA, Guralnik JM, et al. . Middle-aged and mobility-limited prevalence of disability and symptom attributions in a national survey. J Gen Intern Med 2006;21:1091–6. 10.1111/j.1525-1497.2006.00564.x - DOI - PMC - PubMed

Publication types