Background: As chronicity represents one of the major challenges in the healthcare of aging populations, the understanding of how chronic diseases distribute and co-occur in this part of the population is needed. Objectives: The aims of this study were to evaluate and compare patterns of diseases identified with cluster analysis in two samples of hospitalized elderly. Methods: Data were obtained from the multicenter ‘Registry Politerapie SIMI (REPOSI)' that included people aged 65 or older hospitalized in internal medicine and geriatric wards in Italy during 2008 and 2010. The study sample from the first wave included 1,411 subjects enrolled in 38 hospitals wards, whereas the second wave included 1,380 subjects in 66 wards located in different regions of Italy. To analyze patterns of multimorbidity, a cluster analysis was performed including the same diseases (19 chronic conditions with a prevalence >5%) collected at hospital discharge during the two waves of the registry. Results: Eight clusters of diseases were identified in the first wave of the REPOSI registry and six in the second wave. Several diseases were included in similar clusters in the two waves, such as malignancy and liver cirrhosis; anemia, gastric and intestinal diseases; diabetes and coronary heart disease; chronic obstructive pulmonary disease and prostate hypertrophy. Conclusion: These findings strengthened the idea of an association other than by chance of diseases in the elderly population.

1.
Marengoni A, Angleman S, Melis R, et al: Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011;10:430-439.
2.
Marengoni A, Fratiglioni L: Disease clusters in older adults: rationale and need for investigation. J Am Geriatr Soc 2011;59:2395-2396.
3.
Vogt W, Nagel D: Cluster analysis in diagnosis. Clin Chem 1992;38:182-198.
4.
Nobili A, Licata G, Salerno F, et al, SIMI Investigators: Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards: the REPOSI study. Eur J Clin Pharmacol 2011;67:507-519.
5.
World Health Organization: International Classification of Diseases, Injuries, and Causes of Death. Ninth Revision (ICD-9). Geneva, WHO, 1987.
6.
Cornell JE, Pugh JA, Williams JW, Kazis L, et al: Multimorbidity clusters: clustering binary data from multimorbidity clusters: clustering binary data from a large administrative medical database. App Multiv Res 2007;12:163-182.
7.
Gijsen R, Hoeymans N, Schellevis FG, et al: Causes and consequences of comorbidity: a review. J Clin Epidemiol 2001;54:661-674.
8.
Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L: Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc 2009;57:225-230.
9.
Schäfer I, von Leitner EC, Schön G, et al: Multimorbidity patterns in the elderly: a new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS One 2010;5:e15941.
10.
Kirchberger I, Meisinger C, Heier M, et al: Patterns of multimorbidity in the aged population. Results from the KORA-Age study. PLoS One 2012;7:e30556.
11.
Hidalgo CA, Blumm N, Barabási AL, Christakis NA: A dynamic network approach for the study of human phenotypes. PLoS Comput Biol 2009;5:e1000353.
12.
Nakauchi H, Tango T, Umesawa Y, et al: Altered immune responsiveness in patients with glomerulonephritis. Microbiol Immunol 1989;33:1013-1025.
13.
Thakur H, Gupta L, Sobti RC, et al: Association of GSTM1T1 genes with COPD and prostate cancer in north Indian population. Mol Biol Rep 2011;38:1733-1739.
14.
Marengoni A, Bonometti F, Nobili A, et al, Italian Society of Internal Medicine (SIMI) Investigators: In-hospital death and adverse clinical events in elderly patients according to disease clustering: the REPOSI Study. Rejuvenation Res 2010;13:469-477.
15.
Nobili A, Marengoni A, Tettamanti M, et al: Association between clusters of diseases and polypharmacy in hospitalized elderly patients: results from the REPOSI study. Eur J Intern Med 2011;22:597-602.
16.
Newcomer SR, Steiner JF, Bayliss EA: Identifying subgroups of complex patients with cluster analysis. Am J Manag Care 2011;17:e324-e332.
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