TY - JOUR
T1 - Differences in function and recovery profiles between patterns of multimorbidity among older medical patients the first year after an acute admission-An exploratory latent class analysis
AU - Juul-Larsen, Helle Gybel
AU - Andersen, Ove
AU - Bandholm, Thomas
AU - Bodilsen, Ann Christine
AU - Kallemose, Thomas
AU - Jorgensen, Lillian Morch
AU - Klausen, Henrik Hedegaard
AU - Gilkes, Hanne
AU - Petersen, Janne
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Introduction: Multimorbidity is common among older people and may contribute to adverse health effects, such as functional limitations. It may help stratify rehabilitation of older medical patients, if we can identify differences in function under and after an acute medical admission, among patient with different patterns of multimorbidity. Aim: To investigate differences in function and recovery profiles among older medical patients with different patterns of multimorbidity the first year after an acute admission. Methods: Longitudinal prospective cohort study of 369 medical patients (77.9 years, 62% women) acutely admitted to the Emergency Department. During the first 24 h after admission, one month and one year after discharge we assessed mobility level using the de Morton Mobility Index. At baseline and one-year we assessed handgrip strength, gait speed, Barthel20, and the New Mobility Score. Information about chronic conditions was collected by national registers. We used Latent Class Analysis to determine differences among patterns of multimorbidity based on 22 chronic conditions. Results: Four distinct patterns of multimorbidity were identified (Minimal chronic disease; Degenerative, lifestyle, and mental disorders; Neurological, functional and sensory disorders; and Metabolic, pulmonary and cardiovascular disorders). The “Neurological, functional and sensory disorders”-pattern showed significant lower function than the “Minimal chronic disease”-pattern in all outcome measures. There were no differences in recovery profile between patients in the four patterns. Conclusion: The results support that patients with different patterns of multimorbidity among acutely hospitalized older medical patients differ in function, which suggests a differentiated approach towards treatment and rehabilitation warrants further studies.
AB - Introduction: Multimorbidity is common among older people and may contribute to adverse health effects, such as functional limitations. It may help stratify rehabilitation of older medical patients, if we can identify differences in function under and after an acute medical admission, among patient with different patterns of multimorbidity. Aim: To investigate differences in function and recovery profiles among older medical patients with different patterns of multimorbidity the first year after an acute admission. Methods: Longitudinal prospective cohort study of 369 medical patients (77.9 years, 62% women) acutely admitted to the Emergency Department. During the first 24 h after admission, one month and one year after discharge we assessed mobility level using the de Morton Mobility Index. At baseline and one-year we assessed handgrip strength, gait speed, Barthel20, and the New Mobility Score. Information about chronic conditions was collected by national registers. We used Latent Class Analysis to determine differences among patterns of multimorbidity based on 22 chronic conditions. Results: Four distinct patterns of multimorbidity were identified (Minimal chronic disease; Degenerative, lifestyle, and mental disorders; Neurological, functional and sensory disorders; and Metabolic, pulmonary and cardiovascular disorders). The “Neurological, functional and sensory disorders”-pattern showed significant lower function than the “Minimal chronic disease”-pattern in all outcome measures. There were no differences in recovery profile between patients in the four patterns. Conclusion: The results support that patients with different patterns of multimorbidity among acutely hospitalized older medical patients differ in function, which suggests a differentiated approach towards treatment and rehabilitation warrants further studies.
KW - Acute hospitalization
KW - Older medical patients
KW - Function
KW - Mobility
KW - Multimorbidity
U2 - 10.1016/j.archger.2019.103956
DO - 10.1016/j.archger.2019.103956
M3 - Journal article
C2 - 31586786
SN - 0167-4943
VL - 86
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
M1 - 103956
ER -