Epidemiology and Health

Original Articles

Multimorbidity patterns by health-related quality of life status in older adults: an association rules and network analysis utilizing the Korea National Health and Nutrition Examination Survey: Thi-Ngoc Tran, Sanghee Lee, Chang-Mo Oh, Hyunsoon Cho; Epidemiol Health. 2022;44:e2022113. Published online November 29, 2022; DOI: https://doi.org/10.4178/epih.e2022113

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Improved life expectancy has increased the prevalence of older adults living with multimorbidity which likely deteriorates their health-related quality of life (HRQoL). However, relatively little is known about patterns and the relationships of multimorbidity by HRQoL status in older adults.

METHODS

Individuals aged 65 or older from the Korea National Health and Nutrition Examination Survey V-VII (2010-2018) were analyzed. HRQoL was assessed by the EuroQoL-5 dimensions questionnaire and categorized as poor, normal, or good. The impact of multimorbidity on HRQoL was evaluated using logistic regression. The patterns and inter-relationships between multimorbidity, stratified by HRQoL groups, were analyzed using the association rules and network analysis approach.

RESULTS

Multimorbidity was significantly associated with poor HRQoL (3 or more diseases vs. none; adjusted odds ratio, 2.70; 95% confidence interval, 2.10 to 3.46). Hypertension, arthritis, hyperlipidemia, and diabetes were the most prevalent diseases across all HRQoL groups. Complex interrelationships of morbidities, higher prevalence, and node strengths in all diseases were observed in the poor HRQoL group, particularly for arthritis, depression, and stroke, compared to other groups (1.5-3.0 times higher, p<0.05 for all). Apart from hypertension, arthritis and hyperlipidemia had a higher prevalence and stronger connections with other diseases in females, whereas this was the case for diabetes and stroke in males with poor HRQoL.

CONCLUSIONS

Multimorbidity patterns formed complicatedly inter-correlated disease networks in the poor HRQoL group with differences according to sex. These findings enhance the understanding of multimorbidity connections and provide information on the healthcare needs of older adults, especially those with poor HRQoL.

Summary

Korean summary
기대 수명의 증가에 따라 고령인구에서 건강관련 삶의 질을 저하시킬 수 있는 복합질환의 유병률도 함께 증가하고 있다. 본 연구에서는 국민건강영양조사 자료를 이용하여 65세 이상 우리나라 고령인구에서 건강관련 삶의 질 (HRQoL)에 따른 복합만성질환 패턴을 분석하였다. 복합만성질환은 건강관련 삶의 질 저하와 통계적으로 유의하게 연관되어 있으며, 연관성 및 네크워크 분석 결과 건강관련 삶의 질이 낮을수록 복합질환의 패턴이 복잡한 것으로 나타났다. 전체적으로 고혈압, 관절염, 고지혈증, 당뇨병이 가장 높은 발생률을 보였다. 건강관련 삶의 질이 낮은 그룹에서는 관절염, 우울증, 뇌졸중 등의 질병이 높은 발생률과 상호관련성을 보였으며, 이는 성별에 따라 차이가 있었다. 연구 결과는 고령자, 특히 건강관련 삶의 질이 낮은 노인의 의료 서비스 요구에 대해 정보를 제공해 줄 수 있을 것이다,

Key Message
Network analysis of older adults (65 or older) in Korea showed that hypertension, arthritis, hyperlipidemia, and diabetes were the most common multimorbidity regardless of HRQoL status. However, as HRQoL deteriorated, multimorbidity patterns formed complicatedly inter-correlated disease networks; the prevalence and the node strength of arthritis, depression, and stroke increased considerably and be diversified by sex.

Citations

Citations to this article as recorded by

Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis
Mi-Sun Lee, Hooyeon Lee
JMIR Public Health and Surveillance.2024; 10: e49433. CrossRef
Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach
Je-Yeon Yun, Young Ho Yun
Scientific Reports.2023;[Epub] CrossRef

Relationship between smoking status and muscle strength in the United States older adults: R. Constance Wiener, Patricia A. Findley, Chan Shen, Nilanjana Dwibedi, Usha Sambamoorthi; Epidemiol Health. 2020;42:e2020055. Published online July 28, 2020; DOI: https://doi.org/10.4178/epih.e2020055

10,490 View
162 Download
4 Web of Science
4 Crossref

Abstract PDF

Abstract

OBJECTIVES
Muscle strength in older adults is associated with greater physical ability. Identifying interventions to maintain muscle strength can therefore improve quality of life. The purpose of this study was to evaluate whether current or former smoking status is associated with a decrease in muscle strength in older adults.

METHODS

Data from the Health and Retirement Study from 2012-2014 were analyzed with regard to maximum dominant hand grip strength, maximum overall hand grip strength, and smoking status (current, former, or never). Unadjusted linear regression was conducted. Other factors known to be related to strength were included in the adjusted linear regression analyses.

RESULTS

For maximum grip strength, the regression coefficient was 4.91 for current smoking (standard error [SE], 0.58; p<0.001), 3.58 for former smoking (SE, 0.43; p<0.001), and 28.12 for never smoking (SE, 0.34). Fully adjusted linear regression on the relationship between dominant hand grip strength and smoking did not yield a significant result. The factors significantly associated with dominant hand grip strength were male sex, younger age, a race/ethnicity of non-Hispanic White or non-Hispanic Black, higher income, morbidity of ≤1 condition, no pain, and moderate or vigorous exercise more than once a week.

CONCLUSIONS

Muscle strength in older adults was not associated with smoking status in the adjusted analysis.

Summary

Citations

Citations to this article as recorded by

Association between smoking status and handgrip strength in Korean male adults: based on Korea National Health and Nutrition Examination Survey 2016–2019
Eunbyul Cho, Hi Sun Soh, Jae-Ryun Lee, Jieun Yun, Woo Kyung Bae, Hyejin Lee
Frontiers in Medicine.2023;[Epub] CrossRef
Handgrip strength, dynapenia, and related factors in postmenopausal women
Pascual García-Alfaro, Sandra García, Ignacio Rodríguez, Faustino R. Pérez-López
Menopause.2022; 29(1): 16. CrossRef
Lower body muscle strength, dynapenic obesity and risk of type 2 diabetes –longitudinal results on the chair-stand test from the Survey of Health, Ageing and Retirement in Europe (SHARE)
Bernd Kowall
BMC Geriatrics.2022;[Epub] CrossRef
Relationship between Smoking History and Diaphragm Thickness and Muscle Strength in Young Men
Nan-Soo Kim, Young-Su Park
Archives of Orthopedic and Sports Physical Therapy.2020; 16(2): 65. CrossRef

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