Association of multimorbidity patterns and order of physical frailty and cognitive impairment occurrence: a prospective cohort study.

Background Chronic conditions often co-occur in specific disease patterns. Certain chronic diseases contribute to incident frailty or cognitive impairment (CI), but the associations of multimorbidity patterns and the order of frailty and CI occurrence remain unclear. Objectives To determine multimor...

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Publicado en:Age & Ageing Vol. 54; no. 4; pp. 1 - 11
Autores principales: Wang, Shuomin, Li, Qianyuan, Hu, Jianzhong, Chen, Qirong, Wang, Shanshan, Xue, Qian-Li, Huang, Chongmei, Sun, Hongyu, Liu, Minhui
Formato: Artículo
Publicado: Oxford University Press / USA Apr2025
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2025
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      pub: Oxford University Press / USA
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        10.1093/ageing/afaf101
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        atl: Association of multimorbidity patterns and order of physical frailty and cognitive impairment occurrence: a prospective cohort study.
      aug:
        au:
          Wang, Shuomin
          Li, Qianyuan
          Hu, Jianzhong
          Chen, Qirong
          Wang, Shanshan
          Xue, Qian-Li
          Huang, Chongmei
          Sun, Hongyu
          Liu, Minhui
        affil:
          Xiangya School of Nursing, Central South University, Changsha, China
          National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, China
          School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
          School of Medicine, Johns Hopkins University, Baltimore, United States
          School of Nursing, Ningxia Medical University, Yinchuan, China
          School of Nursing, Peking University, Beijing, China
      su:
        Disease risk factors
        Old age
        Cognition disorder risk factors
        Risk assessment
        Research funding
        Independent living
        Frail elderly
        Structural equation modeling
        Cardiovascular diseases risk factors
        Descriptive statistics
        Longitudinal method
        Comorbidity
        Physical activity
      sug:
        subj:
          Disease risk factors
          Old age
          Cognition disorder risk factors
          Risk assessment
          Research funding
          Independent living
          Frail elderly
          Structural equation modeling
          Cardiovascular diseases risk factors
          Descriptive statistics
          Longitudinal method
          Comorbidity
          Physical activity
      keyword:
        cognitive impairment
        frailty
        latent class analysis
        multimorbidity
        multimorbidity pattern
        older adult
        older people
        physical frailty
        prospective studies
        cognitive impairment
        frailty
        latent class analysis
        multimorbidity
        multimorbidity pattern
        older adult
        older people
        physical frailty
        prospective studies
      ab: Background Chronic conditions often co-occur in specific disease patterns. Certain chronic diseases contribute to incident frailty or cognitive impairment (CI), but the associations of multimorbidity patterns and the order of frailty and CI occurrence remain unclear. Objectives To determine multimorbidity patterns amongst older adults and their associations with the order of frailty and CI occurrence. Design Prospective cohort study. Methods Using data from National Health and Aging Trends Study, 7522 community-dwelling participants were included and followed up for four years. Latent class analysis was conducted to identify multimorbidity patterns with clinical meaningfulness. Fine and Grey competing risks models were used to examine the associations between multimorbidity patterns and different orders of frailty and CI occurrence (frailty-first, CI-first, frailty-CI co-occurrence). Results Four multimorbidity patterns were identified: cardiometabolic, osteoarticular, cancer-dominated and psychiatric/multisystem pattern. Compared to non-multimorbidity, all four multimorbidity patterns were associated with a higher risk of developing frailty-first, but not developing CI-first. Specifically, the psychiatric/multisystem pattern had the highest risk of developing frailty-first ( Sub-distribution hazard ratios [SHR] = 3.74, 95% confidence intervals = 2.96, 4.71), followed by osteoarticular pattern (SHR = 2.53, 95% CI = 1.98, 3.22) and cardiometabolic pattern (SHR =2.41, 95% confidence intervals = 1.96, 2.98). In addition, only participants from psychiatric/multisystem and cardiometabolic pattern showed a higher risk of frailty-CI co-occurrence. Conclusions Our findings highlight the etiological heterogeneity between physical frailty and CI. Clinician should be aware of multimorbidity clusters and thus provide more effective strategies for comorbid older adults to prevent the onset of these two geriatric syndromes.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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