Comorbidity clusters and mental health

Ljiljana Majnaric, Tomislav Kurevija, Dunja Šojat, Tamer Salha, Matea Matić-Ličanin, Mario Ćurković

Keywords: Comorbidity clusters, somatic disease, mental health

Background:

The global trend of population aging has led to a constant increase in the number of people with multiple comorbid conditions (MCCs). Certain conditions tend to occur in consistent clusters, while others present in various combinations. Individuals with MCCs often experience poor mental health, which in turn diminishes their functional abilities and contributes to the development of new co-occurring conditions

Research questions:

Which combinations of MCCs are associated with poor mental health, including anxiety, depression, and cognitive impairment?

Method:

The sample consisted of 189 older individuals (58% female) aged over 60 years (mean age 78.47±6.65) who had visited two family doctor's teams at the Health Center Osijek for reasons unrelated to this study over 6 months. Demographic data and diagnoses related to physical health were extracted from the patient's e-health records. Mental health and cognitive function were evaluated using standard tests, including the Geriatric Anxiety Scale, the Geriatric Depression Scale, and the 6-item cognitive impairment test. The clusters were identified based on 14 diagnoses using Latent Profile Analysis after dimensionality reduction. Participants from different clusters were compared on their mental health and cognitive function using one-way ANOVA and the Games-Howell post hoc test.

Results:

The identified clusters were labeled based on the most common diagnoses as follows: Hypertension and Osteoarthritis (H+O), type 2 Diabetes, Osteoarthritis, Chronic Pain, and Sensory Impairment (D+O+CP+SI), Cerebrovascular diseases, Urinary bladder diseases and Constipation (CV+U+C), and Low Comorbidity (LC). Participants from the D+O+CP+SI and H+O clusters showed higher levels of anxiety. Those from the D+O+CP+SI cluster also scored higher on the depressive dysphoria scale, compared to the LC cluster. The D+O+CP+SI cluster had the most significant impact on cognitive ability.

Conclusions:

Mental health disorders and cognitive impairment may be expected in older individuals with MCC clusters, especially those involving type 2 diabetes.

Points for discussion:

#44