IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i16p10180-d890161.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/16/10180/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/16/10180/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ignatios Ioakeim-Skoufa & Beatriz Poblador-Plou & Jonás Carmona-Pírez & Jesús Díez-Manglano & Rokas Navickas & Luis Andrés Gimeno-Feliu & Francisca González-Rubio & Elena Jureviciene & Laimis Dambraus, 2020. "Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    2. Ingmar Schäfer & Eike-Christin von Leitner & Gerhard Schön & Daniela Koller & Heike Hansen & Tina Kolonko & Hanna Kaduszkiewicz & Karl Wegscheider & Gerd Glaeske & Hendrik van den Bussche, 2010. "Multimorbidity Patterns in the Elderly: A New Approach of Disease Clustering Identifies Complex Interrelations between Chronic Conditions," PLOS ONE, Public Library of Science, vol. 5(12), pages 1-10, December.
    3. Miguel Ángel Hernández-Rodríguez & Ermengol Sempere-Verdú & Caterina Vicens-Caldentey & Francisca González-Rubio & Félix Miguel-García & Vicente Palop-Larrea & Ramón Orueta-Sánchez & Óscar Esteban-Jim, 2021. "Drug Prescription Profiles in Patients with Polypharmacy in Spain: A Large-Scale Pharmacoepidemiologic Study Using Real-World Data," IJERPH, MDPI, vol. 18(9), pages 1-10, April.
    4. Palmer, Katie & Marengoni, Alessandra & Forjaz, Maria João & Jureviciene, Elena & Laatikainen, Tiina & Mammarella, Federica & Muth, Christiane & Navickas, Rokas & Prados-Torres, Alexandra & Rijken, Mi, 2018. "Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)," Health Policy, Elsevier, vol. 122(1), pages 4-11.
    5. Christopher J. M. Whitty & Fiona M. Watt, 2020. "Map clusters of diseases to tackle multimorbidity," Nature, Nature, vol. 579(7800), pages 494-496, March.
    6. Beatriz Poblador-Plou & Jonás Carmona-Pírez & Ignatios Ioakeim-Skoufa & Antonio Poncel-Falcó & Kevin Bliek-Bueno & Mabel Cano-del Pozo & Luis Andrés Gimeno-Feliú & Francisca González-Rubio & Mercedes , 2020. "Baseline Chronic Comorbidity and Mortality in Laboratory-Confirmed COVID-19 Cases: Results from the PRECOVID Study in Spain," IJERPH, MDPI, vol. 17(14), pages 1-14, July.
    7. James W. Vaupel, 2010. "Biodemography of human ageing," Nature, Nature, vol. 464(7288), pages 536-542, March.
    8. Sara Mucherino & Antonio Gimeno-Miguel & Jonas Carmona-Pirez & Francisca Gonzalez-Rubio & Ignatios Ioakeim-Skoufa & Aida Moreno-Juste & Valentina Orlando & Mercedes Aza-Pascual-Salcedo & Beatriz Pobla, 2021. "Changes in Multimorbidity and Polypharmacy Patterns in Young and Adult Population over a 4-Year Period: A 2011–2015 Comparison Using Real-World Data," IJERPH, MDPI, vol. 18(9), pages 1-20, April.
    9. Katie Palmer & Angelo Carfì & Carmen Angioletti & Antonella Di Paola & Rokas Navickas & Laimis Dambrauskas & Elena Jureviciene & Maria João Forjaz & Carmen Rodriguez-Blazquez & Alexandra Prados-Torres, 2019. "A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS," IJERPH, MDPI, vol. 16(24), pages 1-18, December.
    10. Jonás Carmona-Pírez & Ignatios Ioakeim-Skoufa & Antonio Gimeno-Miguel & Beatriz Poblador-Plou & Francisca González-Rubio & Dolores Muñoyerro-Muñiz & Juliana Rodríguez-Herrera & Juan Antonio Goicoechea, 2022. "Multimorbidity Profiles and Infection Severity in COVID-19 Population Using Network Analysis in the Andalusian Health Population Database," IJERPH, MDPI, vol. 19(7), pages 1-13, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ignatios Ioakeim-Skoufa & Beatriz Poblador-Plou & Jonás Carmona-Pírez & Jesús Díez-Manglano & Rokas Navickas & Luis Andrés Gimeno-Feliu & Francisca González-Rubio & Elena Jureviciene & Laimis Dambraus, 2020. "Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    2. Carmen Rodriguez-Blazquez & Maria João Forjaz & Antonio Gimeno-Miguel & Kevin Bliek-Bueno & Beatriz Poblador-Plou & Sara Pilar Luengo-Broto & Inmaculada Guerrero-Fernández de Alba & Ana Maria Carriazo, 2020. "Assessing the Pilot Implementation of the Integrated Multimorbidity Care Model in Five European Settings: Results from the Joint Action CHRODIS-PLUS," IJERPH, MDPI, vol. 17(15), pages 1-14, July.
    3. Jonás Carmona-Pírez & Ignatios Ioakeim-Skoufa & Antonio Gimeno-Miguel & Beatriz Poblador-Plou & Francisca González-Rubio & Dolores Muñoyerro-Muñiz & Juliana Rodríguez-Herrera & Juan Antonio Goicoechea, 2022. "Multimorbidity Profiles and Infection Severity in COVID-19 Population Using Network Analysis in the Andalusian Health Population Database," IJERPH, MDPI, vol. 19(7), pages 1-13, March.
    4. Maria João Forjaz & Carmen Rodriguez-Blazquez & Inmaculada Guerrero-Fernández de Alba & Antonio Gimeno-Miguel & Kevin Bliek-Bueno & Alexandra Prados-Torres & on behalf of the CHRODIS Expert Group on M, 2019. "Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health," IJERPH, MDPI, vol. 16(24), pages 1-13, December.
    5. Jonás Carmona-Pírez & Beatriz Poblador-Plou & Antonio Poncel-Falcó & Jessica Rochat & Celia Alvarez-Romero & Alicia Martínez-García & Carmen Angioletti & Marta Almada & Mert Gencturk & A. Anil Sinaci , 2022. "Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and Their Association with Mortality through a Frequent Pattern Growth Association Algorithm," IJERPH, MDPI, vol. 19(4), pages 1-10, February.
    6. Edouard Debonneuil & Anne Eyraud-Loisel & Frédéric Planchet, 2017. "Conditions Of Interest Of A Longevity Megafund For Pension Funds," Working Papers hal-01571937, HAL.
    7. D. Dragone & H. Strulik, 2017. "Human Health and Aging over an Infinite Time Horizon," Working Papers wp1104, Dipartimento Scienze Economiche, Universita' di Bologna.
    8. Nicole L. Van Der Gaag & Govert Ewout Bijwaard & Joop de Beer & Luc Bonneux, 2015. "A multistate model to project elderly disability in case of limited data," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 32(3), pages 75-106.
    9. Melinda Heinz & Nicholas Cone & Grace Da Rosa & Alex J. Bishop & Tanya Finchum, 2017. "Examining Supportive Evidence for Psychosocial Theories of Aging within the Oral History Narratives of Centenarians," Societies, MDPI, vol. 7(2), pages 1-21, April.
    10. Duncan Gillespie & Meredith Trotter & Shripad Tuljapurkar, 2014. "Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1003-1017, June.
    11. Francisco Ruiz-Dominguez & Ingrid Stegeman & Javier Dolz-López & Lina Papartyte & Dolores Fernández-Pérez, 2021. "Transfer and Implementation Process of a Good Practice in Workplace Health Promotion," IJERPH, MDPI, vol. 18(10), pages 1-17, May.
    12. Gregorio Gimenez & Ana Isabel Gil-Lacruz & Marta Gil-Lacruz, 2021. "Is Happiness Linked to Subjective Life Expectancy? A Study of Chilean Senior Citizens," Mathematics, MDPI, vol. 9(17), pages 1-12, August.
    13. Kashnitsky, Ilya, 2017. "A cohort is not representative of humanity," OSF Preprints 524kg, Center for Open Science.
    14. Edouard Debonneuil & Anne Eyraud-Loisel & Frédéric Planchet, 2018. "Can Pension Funds Partially Manage Longevity Risk by Investing in a Longevity Megafund?," Risks, MDPI, vol. 6(3), pages 1-27, July.
    15. Caballer-Tarazona, Vicent & Guadalajara-Olmeda, Natividad & Vivas-Consuelo, David, 2019. "Predicting healthcare expenditure by multimorbidity groups," Health Policy, Elsevier, vol. 123(4), pages 427-434.
    16. Gabriele Doblhammer & Gerard J van den Berg & Thomas Fritze, 2013. "Economic Conditions at the Time of Birth and Cognitive Abilities Late in Life: Evidence from Ten European Countries," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-12, September.
    17. Antonio Sarría-Santamera & Lorena Pinilla-Navas & Patricia González-Soriano & Iñaki Imaz-Iglesia & Teresa Moreno-Casbas & Teresa Corral, 2020. "Lessons from the Implementation of Pilot Practices to Tackle the Burden of Noncommunicable Diseases in Europe," IJERPH, MDPI, vol. 17(13), pages 1-6, June.
    18. Felipe Vásquez & Gibran Vita & Daniel B. Müller, 2018. "Food Security for an Aging and Heavier Population," Sustainability, MDPI, vol. 10(10), pages 1-19, October.
    19. Litchfield, Ian & Kingston, Beth & Narga, Dee & Turner, Alice, 2022. "The move towards integrated care: Lessons learnt from managing patients with multiple morbidities in the UK," Health Policy, Elsevier, vol. 126(8), pages 777-785.
    20. McCarthy, David G. & Wang, Po-Lin, 2021. "Pooling mortality risk in Eurozone state pension liabilities: An application of a Bayesian coherent multi-population cohort-based mortality model," Insurance: Mathematics and Economics, Elsevier, vol. 99(C), pages 459-485.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10180-:d:890161. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.