Tripathy Jaya Prasad, Yedhu S
Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India.
National Institute of Epidemiology, Chennai, India.
Psychogeriatrics. 2025 Sep;25(5):e70084. doi: 10.1111/psyg.70084.
Multiple comorbidities are common amongst the elderly due to shared underlying factors. We used latent class analysis (LCA) to explore the of multimorbidities amongst the elderly and their association with self-rating of health, life satisfaction, limitations in daily activities and depressive symptoms.
We utilised a subset of nationally representative survey data from the Longitudinal Aging Survey of India 2017-2018 covering elderly >= 60 years of age. LCA was used to examine patterns of 11 chronic morbidities. Classes were compared across socio-demographic and behavioural characteristics. Various model fit statistics (Akaike, Bayesian and sample size adjusted Bayesian information criteria, likelihood ratio tests and entropy) and the meaningfulness of the classes were used to select the number of latent classes.
Four distinct latent classes were identified: 'Hypertension/Lung/Bone/Others', 'Cardio-metabolic', 'Hypertension-Diabetes' and the 'Healthy class'. There were significant differences between classes on socio-demographics (age, sex, residence, education, wealth quintile) and behaviours (tobacco, alcohol, physical activity, yoga). 'Hypertension/Lung/Bone/Others' class was significantly associated with limitations in ADLs, limitations in IADLs and depressive symptoms compared to the 'healthy class'. 'Cardio-metabolic' class had significantly higher rates of hospital admission in the last 12 months.
Elderly could be grouped into four distinct classes based on their multimorbidity status. The single-disease paradigm does not fit the approach for caring for patients with multimorbid conditions. Care of multimorbid elderly individuals needs an integrated and continuity of care approach.
由于存在共同的潜在因素，多种合并症在老年人中很常见。我们使用潜在类别分析（LCA）来探讨老年人中多种合并症的模式及其与健康自评、生活满意度、日常活动受限和抑郁症状的关联。
我们利用了2017 - 2018年印度纵向老龄化调查中具有全国代表性的调查数据子集，涵盖60岁及以上的老年人。LCA用于检查11种慢性疾病的模式。对不同社会人口统计学和行为特征的类别进行了比较。使用各种模型拟合统计量（赤池、贝叶斯和样本量调整贝叶斯信息准则、似然比检验和熵）以及类别的意义来选择潜在类别的数量。
确定了四个不同的潜在类别：“高血压/肺部/骨骼/其他”、“心血管代谢”、“高血压 - 糖尿病”和“健康类别”。不同类别在社会人口统计学（年龄、性别、居住、教育、财富五分位数）和行为（烟草、酒精、体育活动、瑜伽）方面存在显著差异。与“健康类别”相比，“高血压/肺部/骨骼/其他”类别与日常生活活动受限、工具性日常生活活动受限和抑郁症状显著相关。“心血管代谢”类别在过去12个月中的住院率显著更高。
老年人可根据其多种合并症状况分为四个不同类别。单一疾病模式不适用于照顾患有多种合并症的患者。对患有多种合并症的老年人的护理需要综合和连续性的护理方法。
