title: Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis.
abstract: OBJECTIVE
  The purpose of this study was to identify clusters of diagnoses in elderly patients with multimorbidity, attended in primary care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  251 primary care centres in Catalonia, Spain.
  
  
  METHODS
  Individuals older than 64 years registered with participating practices.
  
  
  METHODS
  Multimorbidity, defined as the coexistence of 2 or more ICD-10 disease categories in the electronic health record. Using hierarchical cluster analysis, multimorbidity clusters were identified by sex and age group (65-79 and ≥80 years).
  
  
  RESULTS
  322,328 patients with multimorbidity were included in the analysis (mean age, 75.4 years [Standard deviation, SD: 7.4], 57.4% women; mean of 7.9 diagnoses [SD: 3.9]). For both men and women, the first cluster in both age groups included the same two diagnoses: Hypertensive diseases and Metabolic disorders. The second cluster contained three diagnoses of the musculoskeletal system in the 65- to 79-year-old group, and five diseases coincided in the ≥80 age group: varicose veins of the lower limbs, senile cataract, dorsalgia, functional intestinal disorders and shoulder lesions. The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.
  
  
  CONCLUSIONS
  This cluster analysis of elderly primary care patients with multimorbidity, revealed a single cluster of circulatory-metabolic diseases that were the most prevalent in both age groups and sex, and a cluster of second-most prevalent diagnoses that included musculoskeletal diseases. Clusters unknown to date have been identified. The clusters identified should be considered when developing clinical guidance for this population.
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain; University of Girona, Carrer Emili Grahit, 77, Girona, Catalonia, Spain.
authors.forename: Quintí
authors.initials: Q
authors.lastname: Foguet-Boreu
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: Violán
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodriguez-Blanco
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Roso-Llorach
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain; University of Girona, Carrer Emili Grahit, 77, Girona, Catalonia, Spain.
authors.forename: Mariona
authors.initials: M
authors.lastname: Pons-Vigués
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain; University of Girona, Carrer Emili Grahit, 77, Girona, Catalonia, Spain.
authors.forename: Enriqueta
authors.initials: E
authors.lastname: Pujol-Ribera
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain.
authors.forename: Yolima
authors.initials: Y
authors.lastname: Cossio Gil
authors.affiliation: Health Services & Policy Research Group, School of Medicine, University of Exeter, Exeter, United Kingdom.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Valderas
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016000:Cluster Analysis; D015897:Comorbidity; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008659:Metabolic Diseases / Q000453:epidemiology*; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D011320:Primary Health Care; D013030:Spain / Q000453:epidemiology