TY - JOUR
T1 - Clustering by multiple long-term conditions and social care needs
T2 - a cross-sectional study among 10 026 older adults in England
AU - Khan, Nusrat
AU - Chalitsios, Christos V.
AU - Nartey, Yvonne
AU - Simpson, Glenn
AU - Zaccardi, Francesco
AU - Santer, Miriam
AU - Roderick, Paul J.
AU - Stuart, Beth
AU - Farmer, Andrew J.
AU - Dambha-Miller, Hajira
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - 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.
AB - 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.
KW - CLUSTER ANALYSIS
KW - EPIDEMIOLOGY
KW - GERIATRICS
KW - PUBLIC HEALTH
UR - http://www.scopus.com/inward/record.url?scp=85171165035&partnerID=8YFLogxK
U2 - 10.1136/jech-2023-220696
DO - 10.1136/jech-2023-220696
M3 - Article
C2 - 37620006
AN - SCOPUS:85171165035
SN - 0143-005X
VL - 77
SP - 770
EP - 776
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
IS - 12
ER -