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A network-based approach to explore comorbidity patterns among community-dwelling older adults living alone

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Abstract

The detailed comorbidity patterns of community-dwelling older adults have not yet been explored. This study employed a network-based approach to investigate the comorbidity patterns of community-dwelling older adults living alone. The sample comprised a cross-sectional cohort of adults 65 or older living alone in a Korean city (n = 1041; mean age = 77.7 years, 77.6% women). A comorbidity network analysis that estimates networks aggregated from measures of significant co-occurrence between pairs of diseases was employed to investigate comorbid associations between 31 chronic conditions. A cluster detection algorithm was employed to identify specific clusters of comorbidities. The association strength was expressed as the observed-to-expected ratio (OER). As a result, fifteen diseases were interconnected within the network (OER > 1, p-value < .05). While hypertension had a high prevalence, osteoporosis was the most central disease, co-occurring with numerous other diseases. The strongest associations among comorbidities were found between thyroid disease and urinary incontinence, chronic otitis media and osteoporosis, gastric duodenal ulcer/gastritis and anemia, and depression and gastric duodenal ulcer/gastritis (OER > 1.85). Three distinct clusters were identified as follows: (a) cataracts, osteoporosis, chronic otitis media, osteoarthritis/rheumatism, low back pain/sciatica, urinary incontinence, post-accident sequelae, and thyroid diseases; (b) hyperlipidemia, diabetes mellitus, and hypertension; and (c) depression, skin disease, gastric duodenal ulcer/gastritis, and anemia. The results may prove valuable in guiding the early diagnosis, management, and treatment of comorbidities in older adults living alone.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1284).

Author information

Authors and Affiliations

  1. School of Nursing & Health Studies, University of Washington Bothell, 18115 Campus Way NE, Bothell, WA, 98011, USA

    Chiyoung Lee

  2. College of Nursing, Seoul National University, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea

    Yeon-Hwan Park

  3. The Research Institute of Nursing Science, College of Nursing, Seoul National University, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea

    Yeon-Hwan Park

  4. Department of Family Medicine, College of Medicine, Seoul National University, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea

    Belong Cho

  5. Health Promotion Center, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea

    Belong Cho

  6. Clinical Trial Center, Ewha Womans University Mokdong Hospital, 1071 Anyangcheon-Ro, Yangcheon-Gu, Seoul, 07985, Republic of Korea

    Hye Ah Lee

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  1. Chiyoung Lee
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Contributions

Conceptualization: CL, YHP; methodology: HAL, CL; formal analysis and investigation: CL; writing—original draft preparation: CL; writing—review and editing: YHP, BC, HAL; funding acquisition: BC, YHP; supervision: YHP, BC.

Corresponding author

Correspondence to Yeon-Hwan Park.

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Ethics approval

The original research project, “Development of a community-based integrated service model for older adults living alone,” was approved by the Seoul National University Hospital Institutional Review Board (approval no. H-1807–131–961). All participants gave written informed consent prior to enrollment to the study and were informed that they could withdraw their consent at any time during the study without any justification. For the present secondary data analysis, we obtained approval from the Seoul National University Institutional Review Board.

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The authors declare no competing interests.

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Lee, C., Park, YH., Cho, B. et al. A network-based approach to explore comorbidity patterns among community-dwelling older adults living alone. GeroScience 46, 2253–2264 (2024). https://doi.org/10.1007/s11357-023-00987-z

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  • DOI: https://doi.org/10.1007/s11357-023-00987-z

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