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Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort

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  • Ignatios Ioakeim-Skoufa

    (WHO Collaborating Centre for Drug Statistics Methodology, Department of Drug Statistics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, NO-0213 Oslo, Norway
    EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), ES-08009 Barcelona, Spain
    These authors contributed equally to this work.)

  • Mercedes Clerencia-Sierra

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Aragon Health Service (SALUD), Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, ES-28029 Madrid, Spain)

  • Aida Moreno-Juste

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Aragon Health Service (SALUD), Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, ES-28029 Madrid, Spain)

  • Carmen Elías de Molins Peña

    (Aragon Health Service (SALUD), Miguel Servet University Hospital, ES-50009 Zaragoza, Spain)

  • Beatriz Poblador-Plou

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, ES-28029 Madrid, Spain)

  • Mercedes Aza-Pascual-Salcedo

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, ES-28029 Madrid, Spain
    Primary Care Pharmacy Service Zaragoza III, Aragon Health Service (SALUD), ES-50017 Zaragoza, Spain)

  • Francisca González-Rubio

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), ES-08009 Barcelona, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain)

  • Alexandra Prados-Torres

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, ES-28029 Madrid, Spain
    These authors contributed equally to this work.)

  • Antonio Gimeno-Miguel

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, ES-50009 Zaragoza, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, ES-28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, ES-28029 Madrid, Spain
    These authors contributed equally to this work.)

Abstract

Multimorbidity is challenging for both patients and healthcare systems due to its increasing prevalence and high impact on people’s health and well-being. The risk of multimorbidity increases with age, but there is still more to discover regarding the clinical profile of the oldest old. In this study, we used information from the EpiChron Cohort Study to identify multimorbidity patterns in individuals who died during the period 2010–2019 at the ages of 80–89, 90–99, and ≥100. This cohort links the demographic, clinical, and drug dispensation information of public health system users in Aragón, Spain. We saw a significantly lower number of chronic diseases and drugs and a lower prevalence of polypharmacy in centenarians compared to those aged 80–99. K-means clustering revealed different multimorbidity clusters by sex and age group. We observed clusters of cardiovascular and metabolic diseases, obstructive pulmonary conditions, and neoplasms, amongst other profiles. One in three octogenarian women had a metabolic pattern (diabetes, dyslipidaemia, and other endocrine–metabolic disorders) with the highest number of diseases (up to seven) and prevalence of polypharmacy (64%). We observed clusters of dementia and genitourinary disorders in individuals on medication with anticholinergic activity. Our study offers an opportunity to better understand the urgency of adequately addressing multimorbidity in our older adults.

Suggested Citation

  • Ignatios Ioakeim-Skoufa & Mercedes Clerencia-Sierra & Aida Moreno-Juste & Carmen Elías de Molins Peña & Beatriz Poblador-Plou & Mercedes Aza-Pascual-Salcedo & Francisca González-Rubio & Alexandra Prad, 2022. "Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort," IJERPH, MDPI, vol. 19(16), pages 1-15, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10180-:d:890161
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    1. Xisco Reus & Maria Lluisa Sastre & Alfonso Leiva & Belén Sánchez & Cristina García-Serra & Ignatios Ioakeim-Skoufa & Caterina Vicens, 2022. "LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care," IJERPH, MDPI, vol. 19(20), pages 1-10, October.

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