Bazo-Alvarez, Juan Carlos;
Del Castillo, Darwin;
Piza, Luis;
Bernabe-Ortiz, Antonio;
Carrillo-Larco, Rodrigo M;
Smeeth, Liam;
Gilman, Robert H;
... Miranda, J Jaime; + view all
(2024)
Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings.
American Journal of Epidemiology
, Article kwae466. 10.1093/aje/kwae466.
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Abstract
Multimorbidity data typically are analyzed by tallying disease counts, an approach that overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analyzed 8-year follow-up data of people aged 35 years or older who were part of the CRONICAS Cohort Study, a multisite cohort from Peru. First, we used Partitioning Around Medoids and multidimensional scaling to identify multimorbidity clusters. We then estimated the association between multimorbidity clusters and all-cause mortality. Second, we identified subpopulations using finite mixture modeling. Our analysis revealed three clusters of chronic conditions: respiratory (cluster 1: bronchitis, chronic obstructive pulmonary disease, and asthma); lifestyle, hypertension, depression, and diabetes (cluster 2); and circulatory (cluster 3: heart disease, stroke, and peripheral artery disease). Although only the cluster comprising circulatory diseases showed a significant association with all-cause mortality in the overall population, we identified two latent subpopulations (named I and II) exhibiting differential mortality risks associated with specific multimorbidity clusters. These findings underscore the importance of considering multimorbidity clusters and sociodemographic characteristics in understanding mortality risks. They also highlight the need for tailored interventions to address the unique needs of different subpopulations living with multimorbidity to reduce mortality risks effectively.
| Type: | Article |
|---|---|
| Title: | Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/aje/kwae466 |
| Publisher version: | https://doi.org/10.1093/aje/kwae466 |
| Language: | English |
| Keywords: | cluster analysis, EDUCATION, HEALTH-CARE, IMPACT, Life Sciences & Biomedicine, low- and middle-income countries, LOW-INCOME, MORBIDITY, mortality risk, multimorbidity patterns, NONCOMMUNICABLE DISEASES, PREVALENCE, PRIMARY-CARE, Public, Environmental & Occupational Health, RISK-FACTORS, Science & Technology, sociodemographic characteristics, SOCIOECONOMIC-STATUS, unsupervised machine learning |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10219956 |
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