PMID- 29338690
OWN - NLM
STAT- MEDLINE
DCOM- 20180709
LR  - 20231112
IS  - 1471-2318 (Electronic)
IS  - 1471-2318 (Linking)
VI  - 18
IP  - 1
DP  - 2018 Jan 16
TI  - Multimorbidity patterns in the elderly: a prospective cohort study with cluster 
      analysis.
PG  - 16
LID - 10.1186/s12877-018-0705-7 [doi]
LID - 16
AB  - BACKGROUND: Multimorbidity is the coexistence of more than two chronic diseases 
      in the same individual; however, there is no consensus about the best definition. 
      In addition, few studies have described the variability of multimorbidity 
      patterns over time. The aim of this study was to identify multimorbidity patterns 
      and their variability over a 6-year period in patients older than 65 years 
      attended in primary health care. METHODS: A cohort study with yearly 
      cross-sectional analysis of electronic health records from 50 primary health care 
      centres in Barcelona. Selected patients had multimorbidity and were 65 years of 
      age or older in 2009. Diagnoses (International Classification of Primary Care, 
      second edition) were extracted using O'Halloran criteria for chronic diseases. 
      Multimorbidity patterns were identified using two steps: 1) multiple 
      correspondence analysis and 2) k-means clustering. Analysis was stratified by sex 
      and age group (65-79 and >/=80 years) at the beginning of the study period. 
      RESULTS: Analysis of 2009 electronic health records from 190,108 patients with 
      multimorbidity (59.8% women) found a mean age of 71.8 for the 65-79 age group and 
      84.16 years for those over 80 (Standard Deviation [SD] 4.35 and 3.46, 
      respectively); the median number of chronic diseases was seven (Interquartil 
      range [IQR] 5-10). We obtained 6 clusters of multimorbidity patterns (1 
      nonspecific and 5 specifics) in each group, being the specific ones: 
      Musculoskeletal, Endocrine-metabolic, Digestive/Digestive-respiratory, 
      Neurological, and Cardiovascular patterns. A minimum of 42.5% of the sample 
      remained in the same pattern at the end of the study, reflecting the stability of 
      these patterns. CONCLUSIONS: This study identified six multimorbidity patterns 
      per each group, one nonnspecific pattern and five of them with a specific pattern 
      related to an organic system. The multimorbidity patterns obtained had similar 
      characteristics throughout the study period. These data are useful to improve 
      clinical management of each specific subgroup of patients showing a particular 
      multimorbidity pattern.
FAU - Guisado-Clavero, Marina
AU  - Guisado-Clavero M
AD  - Institut Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi 
      Gol), Gran Via Corts Catalanes, 587 atic, 08007, Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain.
AD  - Gerencia d'Ambit d'Atencio Primaria Barcelona Ciutat, Institut Catala de la 
      Salut, Carrer de Balmes, 22, Barcelona, Spain.
FAU - Roso-Llorach, Albert
AU  - Roso-Llorach A
AD  - Institut Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi 
      Gol), Gran Via Corts Catalanes, 587 atic, 08007, Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain.
FAU - Lopez-Jimenez, Tomas
AU  - Lopez-Jimenez T
AD  - Institut Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi 
      Gol), Gran Via Corts Catalanes, 587 atic, 08007, Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain.
FAU - Pons-Vigues, Mariona
AU  - Pons-Vigues M
AD  - Institut Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi 
      Gol), Gran Via Corts Catalanes, 587 atic, 08007, Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain.
AD  - Faculty of Nursing, Universitat de Girona, Emili Grahit, 77, 17071, Girona, 
      Spain.
FAU - Foguet-Boreu, Quinti
AU  - Foguet-Boreu Q
AD  - Institut Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi 
      Gol), Gran Via Corts Catalanes, 587 atic, 08007, Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain.
AD  - Department of Psychiatry, Hospital Universitari de Vic, Francesc Pla el Vigata, 
      1, 08500, Vic, Spain.
FAU - Munoz, Miguel Angel
AU  - Munoz MA
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain.
AD  - Gerencia d'Ambit d'Atencio Primaria Barcelona Ciutat, Institut Catala de la 
      Salut, Carrer de Balmes, 22, Barcelona, Spain.
AD  - Unitat de Suport a la Recerca, Institut Universitari d'Investigacio en Atencio 
      Primaria Jordi Gol (IDIAP Jordi Gol), Carrer de Sardenya, 375, Barcelona, Spain.
FAU - Violan, Concepcion
AU  - Violan C
AD  - Institut Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi 
      Gol), Gran Via Corts Catalanes, 587 atic, 08007, Barcelona, Spain. 
      cviolan@idiapjgol.org.
AD  - Universitat Autonoma de Barcelona, Campus de la UAB, Placa Civica, 08193, 
      Bellaterra (Cerdanyola del Valles), Barcelona, Spain. cviolan@idiapjgol.org.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180116
PL  - England
TA  - BMC Geriatr
JT  - BMC geriatrics
JID - 100968548
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease/epidemiology
MH  - Cluster Analysis
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Electronic Health Records/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Male
MH  - Multimorbidity/*trends
MH  - Primary Health Care/*methods
MH  - Prospective Studies
MH  - Spain/epidemiology
PMC - PMC5771078
OTO - NOTNLM
OT  - Ageing
OT  - Chronic disease
OT  - Cluster analysis
OT  - Electronic health record
OT  - Multimorbidity
OT  - Primary health care
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The protocol of the study was 
      approved by the Committee on the Ethics of Clinical Research, Institut 
      Universitari d'Investigacio en Atencio Primaria Jordi Gol (IDIAP Jordi Gol) 
      (Protocol No: P15/149). All data were anonymized and the confidentiality of EHR 
      was respected at all times in accordance with national and international law. 
      CONSENT FOR PUBLICATION: Not applicable COMPETING INTERESTS: The authors declare 
      that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains 
      neutral with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2018/01/18 06:00
MHDA- 2018/07/10 06:00
PMCR- 2018/01/16
CRDT- 2018/01/18 06:00
PHST- 2017/09/20 00:00 [received]
PHST- 2018/01/01 00:00 [accepted]
PHST- 2018/01/18 06:00 [entrez]
PHST- 2018/01/18 06:00 [pubmed]
PHST- 2018/07/10 06:00 [medline]
PHST- 2018/01/16 00:00 [pmc-release]
AID - 10.1186/s12877-018-0705-7 [pii]
AID - 705 [pii]
AID - 10.1186/s12877-018-0705-7 [doi]
PST - epublish
SO  - BMC Geriatr. 2018 Jan 16;18(1):16. doi: 10.1186/s12877-018-0705-7.