Multimorbidity clusters and their associations with health-related quality of life in two UK cohorts

作者：Lewis Steell, Stefanie J. Krauth, Sayem Ahmed, Grace Olivia Dibben, Emma McIntosh, Peter Hanlon, Jim Lewsey, Barbara I. Nicholl, David McAllister, Susan M. Smith, Rachael A Evans, Zahira Ahmed, Sarah Gerard Dean, Colin James Greaves, Shaun R. Barber, Patrick Doherty, Nikki Gardiner, Tracy R. Ibbotson, Kate B Jolly, Paula Ormandy, Sharon Anne Simpson, Rod Stephen Taylor, Sally J. Singh, Frances S Mair, Bhautesh Jani · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-024-03811-3 · 被引用次数：31 · 研究领域：Chronic Disease Management Strategies、Primary Care and Health Outcomes、Machine Learning in Healthcare

BACKGROUND: Identifying clusters of multiple long-term conditions (MLTCs), also known as multimorbidity, and their associated burden may facilitate the development of effective and cost-effective targeted healthcare strategies. This study aimed to identify clusters of MLTCs and their associations with long-term health-related quality of life (HRQoL) in two UK population-based cohorts. METHODS: Age-stratified clusters of MLTCs were identified at baseline in UK Biobank (n = 502,363, 54.6% female) and UKHLS (n = 49,186, 54.8% female) using latent class analysis (LCA). LCA was applied to people who self-reported ≥ 2 LTCs (from n = 43 LTCs [UK Biobank], n = 13 LTCs [UKHLS]) at baseline, across four age-strata: 18-36, 37-54, 55-73, and 74 + years. Associations between MLTC clusters and HRQoL were investigated using tobit regression and compared to associations between MLTC counts and HRQoL. For HRQoL, we extracted EQ-5D index data from UK Biobank. In UKHLS, SF-12 data were extracted and mapped to EQ-5D index scores using a standard preference-based algorithm. HRQoL data were collected at median 5 (UKHLS) and 10 (UK Biobank) years follow-up. Analyses were adjusted for available sociodemographic and lifestyle covariates. RESULTS: LCA identified 9 MLTC clusters in UK Biobank and 15 MLTC clusters in UKHLS. Clusters centred around pulmonary and cardiometabolic LTCs were common across all age groups. Hypertension was prominent across clusters in all ages, while depression featured in you...