Article Impact Level: HIGH Data Quality: STRONG Summary of BMC Medicine, 23(1), 1. https://doi.org/10.1186/s12916-024-03811-3 Dr. Lewis Steell et al.
Points
- The research examined the relationship between clusters of multiple long-term conditions (MLTCs) and health-related quality of life (HRQoL) in two UK cohorts: UK Biobank and UKHLS.
- Nine clusters were identified in UK Biobank and 15 in UKHLS, with overlapping patterns focusing on pulmonary and cardiometabolic conditions across all age groups.
- Depression was more common in younger adults, while painful conditions and arthritis were prevalent in middle-aged and older adults; hypertension was frequent across all clusters.
- MLTC clusters significantly influenced HRQoL, with painful condition clusters causing the most significant deficits in UK Biobank and cardiometabolic clusters showing the lowest HRQoL in UKHLS.
- Healthcare interventions should better address the number and specific types of MLTC clusters to meet the unique needs of various patient populations.
Summary
This study explored the associations between clusters of multiple long-term conditions (MLTCs) and health-related quality of life (HRQoL) in two UK-based cohorts: UK Biobank (n=502,363) and UKHLS (n=49,186). The analysis utilized latent class analysis (LCA) to identify MLTC clusters in individuals who reported two or more long-term conditions (LTCs). These participants were stratified by age: 18-36, 37-54, 55-73, and 74+ years. The research aimed to assess the impact of MLTC clusters on HRQoL, measured using the EQ-5D index in UK Biobank and the SF-12 data in UKHLS, which were mapped to EQ-5D index scores. The study adjusted for sociodemographic and lifestyle factors and followed participants for a median of 5 years in UKHLS and 10 years in UK Biobank.
Nine MLTC clusters were identified in UK Biobank, and 15 clusters were found in UKHLS, with overlapping patterns between the two cohorts. Clusters primarily centered around pulmonary and cardiometabolic LTCs across all age groups. Hypertension was common across clusters, and depression was more prevalent in younger age groups, while painful conditions and arthritis were more frequent in middle-aged and older adults. The study found that MLTC clusters, rather than just the number of LTCs, had significant associations with HRQoL. In the UK Biobank, clusters with high rates of painful conditions showed the most significant deficits in HRQoL. In UKHLS, clusters with a high prevalence of cardiometabolic diseases were associated with the lowest HRQoL.
The study concluded that both the number of LTCs and the specific types of MLTC clusters substantially impact HRQoL. These findings suggest that healthcare strategies and interventions for individuals with multiple long-term conditions should address the total number of conditions and the specific clusters to more effectively cater to the distinct needs of different patient populations.
Link to the article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03811-3
References Steell, L., Krauth, S. J., Ahmed, S., Dibben, G. O., McIntosh, E., Hanlon, P., Lewsey, J., Nicholl, B. I., McAllister, D. A., Smith, S. M., Evans, R., Ahmed, Z., Dean, S., Greaves, C., Barber, S., Doherty, P., Gardiner, N., Ibbotson, T., Jolly, K., … the PERFORM research team. (2025). Multimorbidity clusters and their associations with health-related quality of life in two UK cohorts. BMC Medicine, 23(1), 1. https://doi.org/10.1186/s12916-024-03811-3
