Association between multimorbidity and disability among elderly with chronic obstructive pulmonary disease in Shanghai, China: a cross-sectional study

In the elderly population with chronic obstructive pulmonary disease (COPD), the prevalence of multimorbidity and functional disability is notable, yet the link between these conditions remains somewhat elusive. This investigation seeks to delineate the patterns of multimorbidity and assess their association with functional disability among older COPD sufferers. Utilizing data from the 2023 Unified Needs Assessment Form for Older Adults Care Questionnaire, this research incorporated a latent class analysis (LCA) to categorize multimorbidity patterns in elderly patients afflicted with COPD. These individuals also undertook assessments for activities of daily living (ADL) and instrumental activities of daily living (IADL). Logistic regression analyses were employed to evaluate how the counts and types of multimorbidity associated with functional disabilities. Among 7676 identified COPD patients (mean age: 81.67 ± 8.10 years; 64.75% male), 7074 (92.16%) exhibited multimorbidity. ADL disabilities were found in 70.19% of the cases, whereas IADL disabilities were present in 94.80%. The analysis identified four distinct multimorbidity patterns: metabolic/cardiovascular (63.30%), cardiorespiratory (10.84%), osteoarticular (20.13%), and multisystem involvement (5.73%). All these patterns were significantly linked to increased odds of ADL and IADL disabilities (odds ratio [OR] 1.55, 95% confidence interval [CI] = 1.29–1.86; OR 2.03, 95%CI = 1.76–2.35; OR 1.35, 95%CI = 1.25–1.45 ; OR 1.81, 95%CI = 1.62–2.02) and IADL disability (OR 1.89, 95%CI = 1.38–2.58; OR 2.43, 95%CI = 1.74–3.38; OR 1.25, 95%CI = 1.11–1.42; OR1.35, 95%CI = 1.13–1.61). The findings highlight a high incidence of multimorbidity and functional disabilities among elderly COPD patients in Shanghai, underscoring a significant association between multimorbidity in COPD and increased disability levels. The adoption of patient-centered approaches over traditional disease-centered models in clinical and health management practices may mitigate the impacts of multimorbidity and decrease the risk associated with ADL and IADL disabilities.