Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis

• Published in: PloS one Vol. 10; no. 11; p. e0141155
• Main Authors: Foguet-Boreu, Quintí, Violán, Concepción, Rodriguez-Blanco, Teresa, Roso-Llorach, Albert, Pons-Vigués, Mariona, Pujol-Ribera, Enriqueta, Cossio Gil, Yolima, Valderas, Jose M
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 02-11-2015; Public Library of Science (PLoS)
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Analysis; Cardiovascular Diseases - epidemiology; Care and treatment; Chronic illnesses; Cluster Analysis; Coexistence; Comorbidity; Complications and side effects; Cross-Sectional Studies; Diabetes; Disorders; Elderly; Electronic Health Records; Electronic medical records; Epidemiology; Female; Geriatrics; Health aspects; Health care; Health services; Humans; Hypertension; Hypertension - epidemiology; Information systems; Intestine; Kidney diseases; Lesions; Male; Medical diagnosis; Medical records; Mental Disorders - epidemiology; Metabolic Diseases - epidemiology; Metabolic disorders; Multimorbidity; Musculoskeletal diseases; Musculoskeletal Diseases - epidemiology; Musculoskeletal system; Older people; Pain; Patients; Population; Primary care; Primary Health Care; Public health; Sex; Spain - epidemiology; Studies; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0141155

The purpose of this study was to identify clusters of diagnoses in elderly patients with multimorbidity, attended in primary care.
Cross-sectional study.
251 primary care centres in Catalonia, Spain.
Individuals older than 64 years registered with participating practices.
Multimorbidity, defined as the coexistence of 2 or more ICD-10 disease categories in the electronic health record. Using hierarchical cluster analysis, multimorbidity clusters were identified by sex and age group (65-79 and ≥80 years).
322,328 patients with multimorbidity were included in the analysis (mean age, 75.4 years [Standard deviation, SD: 7.4], 57.4% women; mean of 7.9 diagnoses [SD: 3.9]). For both men and women, the first cluster in both age groups included the same two diagnoses: Hypertensive diseases and Metabolic disorders. The second cluster contained three diagnoses of the musculoskeletal system in the 65- to 79-year-old group, and five diseases coincided in the ≥80 age group: varicose veins of the lower limbs, senile cataract, dorsalgia, functional intestinal disorders and shoulder lesions. The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.
This cluster analysis of elderly primary care patients with multimorbidity, revealed a single cluster of circulatory-metabolic diseases that were the most prevalent in both age groups and sex, and a cluster of second-most prevalent diagnoses that included musculoskeletal diseases. Clusters unknown to date have been identified. The clusters identified should be considered when developing clinical guidance for this population.