Multimorbidity and health-related quality of life among the community-dwelling elderly: A longitudinal study

Objectives: Multimorbidity is a growing public health problem. The objective of this study was to investigate the impact of multimorbidity on health-related quality of life (HRQoL) of the elderly. Methods: A 24-month longitudinal study was conducted on the community-dwelling elderly. There were 411 elderly persons with complete follow-up. Information on thirteen chronic conditions was collected at baseline. Via a multi-dimensional scale, HRQoL was measured at baseline, 18 and 24 months post-baseline, respectively. Exploratory factor analyses were performed to identify multimorbidity patterns. The linear mixed effects models were conducted to analyze the associations between all dimensions of HRQoL and multimorbidity including distinct multimorbidity patterns. Results: Multimorbidity was found to be negatively associated with HRQoL except memory function. We identified three multimorbidity patterns, which were mainly labelled as degenerative disorders, digestive/respiratory disorders, cardiovascular/metabolic disorders, respectively. And three multimorbidity patterns were associated with lower HRQoL including general health, body function, self-care ability and social adaptability. Besides, the elderly with the multimorbidity pattern mainly labelled as digestive/respiratory disorders or cardiovascular/metabolic disorders had a decline on emotion than those without multimorbidity. According to the analysis of the longitudinal data of the sample, general health, self-care ability, emotion and social adaptability of the participants decreased in different degrees every month. Conclusions: Multimorbidity was associated with lower HRQoL of the community-dwelling elderly. Distinct multimorbidity patterns had various impacts on different dimensions of HRQoL. Further studies should be carried out to investigate effective measures to improve HRQoL of the elderly with multimorbidity.