A network-based approach to explore comorbidity patterns among community-dwelling older adults living alone

Geroscience. 2024 Apr;46(2):2253-2264. doi: 10.1007/s11357-023-00987-z. Epub 2023 Nov 4.

Abstract

The detailed comorbidity patterns of community-dwelling older adults have not yet been explored. This study employed a network-based approach to investigate the comorbidity patterns of community-dwelling older adults living alone. The sample comprised a cross-sectional cohort of adults 65 or older living alone in a Korean city (n = 1041; mean age = 77.7 years, 77.6% women). A comorbidity network analysis that estimates networks aggregated from measures of significant co-occurrence between pairs of diseases was employed to investigate comorbid associations between 31 chronic conditions. A cluster detection algorithm was employed to identify specific clusters of comorbidities. The association strength was expressed as the observed-to-expected ratio (OER). As a result, fifteen diseases were interconnected within the network (OER > 1, p-value < .05). While hypertension had a high prevalence, osteoporosis was the most central disease, co-occurring with numerous other diseases. The strongest associations among comorbidities were found between thyroid disease and urinary incontinence, chronic otitis media and osteoporosis, gastric duodenal ulcer/gastritis and anemia, and depression and gastric duodenal ulcer/gastritis (OER > 1.85). Three distinct clusters were identified as follows: (a) cataracts, osteoporosis, chronic otitis media, osteoarthritis/rheumatism, low back pain/sciatica, urinary incontinence, post-accident sequelae, and thyroid diseases; (b) hyperlipidemia, diabetes mellitus, and hypertension; and (c) depression, skin disease, gastric duodenal ulcer/gastritis, and anemia. The results may prove valuable in guiding the early diagnosis, management, and treatment of comorbidities in older adults living alone.

Keywords: Aged; Chronic disease; Comorbidity; Network analysis.

MeSH terms

  • Aged
  • Anemia* / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Duodenal Ulcer* / epidemiology
  • Female
  • Gastritis* / epidemiology
  • Home Environment
  • Humans
  • Hypertension* / epidemiology
  • Independent Living
  • Male
  • Osteoporosis* / epidemiology
  • Otitis Media* / epidemiology
  • Urinary Incontinence* / epidemiology