Abstract
This study aimed to identify multimorbidity patterns and explore the disablement process by utilizing the model raised by Verbrugge and Jette as a theoretical framework. This cross-sectional study used public Long-term Care Insurance (LTCI) claimants’ assessment data of Yiwu city in Zhejiang Province, China, for 2604 individuals aged 60 years and older, from September through December 2018. Latent Class Analysis (LCA) was conducted using 10 common chronic conditions. Structural Equation Modeling was used to examine the disablement process. The latent classes of multimorbidity patterns were the “coronary atherosclerotic heart disease” class (19.0%), the “lower limb fractures” class (26.4%), and the “other diseases” class (54.6%). The structural model results show that coronary atherosclerotic heart disease had a significant influence on incontinence, but it was not statistically significant in predicting vision impairment and mobility impairment. Lower limb fractures had significant effects on vision impairment, incontinence, and mobility impairment. Vision impairment, incontinence, and mobility impairment had significant effects on physical activities of daily living (ADLs). Our findings suggest that different impairments exist from specific patterns of multimorbidity to physical ADL disability, which may provide insights for researchers and policy makers to develop tailored care and provide support for physically disabled older people.
Highlights
Accepted: 4 January 2022The world population is aging rapidly in both developing and developed countries.the risk of disability increases with increasing age [1]
We identified multimorbidity patterns and explored the disablement process in public long-term care insurance claimants in Chinese older adult population
When examining the disablement process among different age groups, we found that coronary atherosclerotic heart disease was significantly associated with mobility impairment among older adults aged 75–84, and lower limb fractures were significantly associated with vision impairment among older adults aged 85 and over
Summary
The risk of disability increases with increasing age [1]. Disability affects the population’s healthy aging, and imposes a heavy burden on family and societies [2]. China has a large, aging population, and it has been predicted that by 2025, China’s population aged over 60 years with a disability (those who experience more than moderate household difficulties) will reach 140 million, and the disability rate in older adults will be. Since 2016, 15 cities in China have implemented an LTCI policy as the first batch of pilot cities [4]. The policy target population is mainly physical disabled older people in the current stage, but will expand to the intellectual disabled, and will cover all ages in the future
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