Classification of general/family medicine patients into subgroups based on differences in the degree of severity of frailty syndrome and affective and cognitive disorders

Abstract

Ciljevi istraživanja Utvrditi kako se pacijenti obiteljske medicine stari 60 ili više godina razvrstavaju u podskupine (latentne klase) na temelju funkcionalnih poremećaja, tjelesne nemoći i kognitivnog deficita. Nacrt istraživanja Istraživanje je presječno istraživanje, provedeno 2018. godine u ambulanti obiteljske medicine u Osijeku. Ispitanici i metode U istraživanju su sudjelovala 263 ispitanika koji su probirani redom dolaska u ambulantu. Za ispitivanje kognitivnih poremećaja korišten je MMSE test (engl. Mini Mental State Examination), a za stupanj tjelesne nemoći frailty test Fried i sur. Za podjelu ispitanika u klase korištena je metoda analize latentnih klasa (softver Mplus 8.1, Muthén & Muthén, 2015), a za ispitivanje razlika u varijablama između klasa standardne statističke metode te multinomijalna regresijska analiza. Razina značajnosti postavljena je na alpha = 0,05 uz dvostrane p-vrijednosti. Rezultati Identificirane su četiri podskupine (latentne klase) koje su nazvane: 1) visoko funkcionalni (N = 161) (aritmetička sredina bodova i SD na frailty testu 0,58 ± 0,72, a na MMSE testu 27,42 ± 1,5); 2) kognitivno slabi (N = 63) (aritmetička sredina bodova i SD na frailty testu 0,97 ± 0,78, a na MMSE testu 21,94 ± 1,95); 3) kognitivno i tjelesno slabi (N = 21) (aritmetička sredina bodova i SD na frailty testu 3,48 ± 1,12, a na MMSE testu 19,14 ± 2,30) i 4) tjelesno slabi (N = 18) (aritmetička sredina bodova i SD na frailty testu 3,61 ± 0,77, a na MMSE testu 24,89 ± 1,81). Zaključak Osobe dobi 60 ili više godina mogu se razvrstati u podskupine prema funkcionalnim sposobnostima.Aims and Objectives To determine how family medicine patients old 60 years or more are classified into subgroups (latent classes) based on their functional abilities represented as degrees of physical frailty and cognitive decline. Study Design The study is a cross-sectional study, conducted in 2018 in a family medicine residency in the town of Osijek. Subjects and Methods The study included 263 patients who were interviewed at regular encounters. The MMSE test (Mini Mental State Examination) was used to examine cognitive disorders, and the degree of physical frailty using the “frailty” test by Fried et al. The latent class analysis method (software Mplus 8.1, Muthén & Muthén, 2015) was used to divide the examinees into classes, and the standard statistical method and multinomial regression analysis were used to examine the differences in the variables between the classes. The significance level was set to alpha = 0.05 with two-sided p-values. Results Four subgroups (latent classes) were identified, based on the results of MMSE and "frailty" tests and were identified as: 1) highly functional (N = 161) (the mean and SD of "frailty" test 0.58 ± 0.72, and of MMSE test 27.42 ± 1.5); 2) cognitively weak (N = 63) (the mean and SD of “frailty” test 0.97 ± 0.78, and of MMSE test 21.94 ± 1.95); 3) cognitively and physically weak (N = 21) (the mean and SD of “frailty” test 3.48 ± 1.12, and of MMSE test 19.14 ± 2.30) and 4) physically weak (N = 18) (the mean and SD of “frailty test 3.61 ± 0.77, and of MMSE test 24.89 ± 1.81). Conclusion Persons old 60 years or more can be classified into subgroups according to their functional abilities