Association of multimorbidity patterns with BADL and IADL impairment among older adults: a cross-sectional study

Abstract

The study aimed to identify prevalent multimorbidity patterns among older adults in Jinan City and examine their associations with basic activities of daily living (BADL) and instrumental activities of daily living (IADL) impairment, so as to provide evidence for health management and disability prevention strategies for older adults. A total of 1758 older adults aged 60 years and above were included in the final analysis. Latent class analysis (LCA) was performed only among participants with two or more chronic conditions ( n  = 517). Participants with zero or one chronic condition ( n  = 1241) were not included in the LCA and were used as the relatively healthy reference group in subsequent analyses. Multinomial logistic regression was used to examine factors associated with membership in the four multimorbidity patterns, and multivariable binary logistic regression was used to examine associations of the five comparison groups with BADL and IADL impairment. Among the 1758 participants, 116 (6.60%) had BADL impairment and 426 (24.23%) had IADL impairment. Overall, 556 participants (31.63%) had no chronic condition, 685 (38.96%) had one chronic condition, and 517 (29.41%) had multimorbidity. Four LCA-derived multimorbidity patterns were identified among participants with multimorbidity: osteoarthrosis-dominant pattern ( n  = 68), stroke-dominant vascular pattern ( n  = 67), diabetes-hypertension metabolic pattern ( n  = 153), and coronary heart disease-dominant pattern ( n  = 229). After adjustment, the osteoarthrosis-dominant pattern was associated with higher odds of both BADL impairment (adjusted odds ratio [OR] = 3.75, 95%CI: 1.81–7.80) and IADL impairment (OR = 2.72, 95%CI: 1.53–4.83). The diabetes-hypertension metabolic pattern (OR = 2.44, 95%CI: 1.34–4.45) and coronary heart disease-dominant pattern (OR = 1.99, 95%CI: 1.19–3.34) were associated with higher odds of BADL impairment. This study identified four multimorbidity patterns among older adults with multimorbidity in Jinan. The associations of different chronic multimorbidity patterns with BADL and IADL impairment were significantly heterogeneous, and the associated factors of different multimorbidity patterns showed different distribution characteristics. These findings may help inform community-based screening and pattern-aware chronic disease management, while longitudinal studies are needed to clarify temporal relationships.