A Latent class analysis of multimorbidity and the relationship to socio-demographic factors and health-related quality of life. A national population-based study of 162,283 Danish Adults

Abstract

Objectives To identify patterns of multimorbidity in the general population and examine how these patterns are related to socio-demographic factors and health-related quality of life. Study design and setting We used latent class analysis to identify subgroups with statistically distinct and clinically meaningful disease patterns in a nationally representative sample of Danish adults (N = 162,283) aged 16+ years. The analysis was based on 15 chronic diseases. Results Seven classes with different disease patterns were identified: A class with no or only a single chronic condition (59% of the population) labeled 1) Relatively Healthy and six classes with a very high prevalence of multimorbidity labeled; 2) Hypertension (14%); 3) Musculoskeletal Disorders (10%); 4) Headache-Mental Disorders (7%); 5) Asthma-Allergy (6%); 6) Complex Cardiometabolic Disorders (3%); and 7) Complex Respiratory Disorders (2%). Female gender was associated with an increased likelihood of belonging to any of the six multimorbidity classes except for class 2 (Hypertension). Low educational attainment predicted membership of all of the multimorbidity classes except for class 5 (Asthma- Allergy). Marked differences in health-related quality of life between the seven latent classes were found. Poor health-related quality of life was highly associated with membership of class 6 (Complex Cardiometabolic Disorders) and class 7 (Complex Respiratory Disorders). Despite different disease patterns, these two classes had nearly identical profiles in relation to health-related quality of life. Conclusion The results clearly support that diseases tend to compound and interact, which suggests that a differentiated public health and treatment approach towards multimorbidity is needed.