A Latent Class Analysis of Multimorbidity and the Relationship to Socio-Demographic Factors and Health-Related Quality of Life. A National Population-Based Study of 162,283 Danish Adults

PLoS One. 2017 Jan 5;12(1):e0169426. doi: 10.1371/journal.pone.0169426. eCollection 2017.

Abstract

Objectives: To identify patterns of multimorbidity in the general population and examine how these patterns are related to socio-demographic factors and health-related quality of life.

Study design and setting: We used latent class analysis to identify subgroups with statistically distinct and clinically meaningful disease patterns in a nationally representative sample of Danish adults (N = 162,283) aged 16+ years. The analysis was based on 15 chronic diseases.

Results: Seven classes with different disease patterns were identified: a class with no or only a single chronic condition (59% of the population) labeled "1) Relatively Healthy" and six classes with a very high prevalence of multimorbidity labeled; "2) Hypertension" (14%); "3) Musculoskeletal Disorders" (10%); "4) Headache-Mental Disorders" (7%); "5) Asthma-Allergy" (6%); "6) Complex Cardiometabolic Disorders" (3%); and "7) Complex Respiratory Disorders" (2%). Female gender was associated with an increased likelihood of belonging to any of the six multimorbidity classes except for class 2 (Hypertension). Low educational attainment predicted membership of all of the multimorbidity classes except for class 5 (Asthma-Allergy). Marked differences in health-related quality of life between the seven latent classes were found. Poor health-related quality of life was highly associated with membership of class 6 (Complex Cardiometabolic Disorders) and class 7 (Complex Respiratory Disorders). Despite different disease patterns, these two classes had nearly identical profiles in relation to health-related quality of life.

Conclusion: The results clearly support that diseases tend to compound and interact, which suggests that a differentiated public health and treatment approach towards multimorbidity is needed.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / epidemiology*
  • Denmark
  • Female
  • Humans
  • Hypertension / epidemiology
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology
  • Public Health
  • Quality of Life*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

The Danish National Health Survey was funded by The Capital Region, Region Zealand, The South Denmark Region, The Central Denmark Region, The North Denmark Region, The Ministry of Interior and Health and the National Institute of Public Health, University of Southern Denmark. The present study (based on secondary data analysis) was funded by The Central Denmark Region. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.