Identifying High-Risk Populations for Cardiometabolic Multimorbidity: A Secondary Analysis of Canadian Longitudinal Study on Aging Data

Nicole Ketter, Mary Jung, Suzanne Huot, Brodie Sakakibara
Purpose:

To develop a parsimonious prediction model of 3-year CM onset, consisting of health condition, personal and environmental factor variables per the International Classification of Functioning, Disability and Health, to develop a profile of high-risk individuals. 

Methods:

This study was an observational, secondary analysis utilizing data from the Canadian Longitudinal Study on Aging (CLSA). The CLSA is a national cohort study in Canada which included those aged 45-85 at time of recruitment. Independent variables included personal factors (age, biological sex, marital status, household income, education, and ethnicity), environmental factors (social support (19-item Medical Outcomes Study: Social Support Survey), personal assistance, and location of residence), and health conditions (stroke, heart disease or heart attack and diabetes). The dependent variable was CM status at the 3-year follow-up assessment. Hierarchical logistic regression analyses with backwards elimination procedures were used to develop the model.

Results:

39 007 participants were included, 824 developed CM. Males (OR: 1.93, 95% CI: 1.65-2.25, p0.001), ≥65 years (OR: 1.51, 95% CI: 1.29-1.76), p0.001), who had stroke (OR: 20.09, 95% CI: 12.88-30.35, p0.001), heart disease (OR: 15.55, 95% CI: 12.60-19.26, p0.001), or diabetes (OR: 12.57, 95% CI: 10.37-15.31, p0.001), had not completed post-secondary school (OR: 1.30, 95% CI: 1.04-1.61, p=0.017), had an income of 50k $CAD (OR: 1.29, 95% CI: 1.10-1.52, p=0.002), and who received home care (OR: 1.56, 95% CI: 1.17-2.04, p=0.002) were at heightened risk of developing CM. 

Conclusion(s):

The findings emphasize the need for targeted prevention strategies in populations identified as having a heightened high-risk of CM onset. Future work includes developing specific prevention interventions relevant for this population. 

Implications:

Health promotion efforts should prioritize early screening and intervention for individuals at a higher risk which may effectively reduce CM incidence. Physiotherapists could develop tailored prevention and rehabilitation programs that address known risk factors of CM. Such interventions may focus on mobility, physical activity, and chronic disease self-management personalized to the contexts of the population at a heightened risk. 

Funding acknowledgements:
Canadian Institute for Health Research (CIHR) CGS-M program, Pritchard Foundation from UBCO. CLSA funding through the CIHR.
Keywords:
Cardiometabolic Multimorbidity
Prevention Strategies
Risk Prediction Model
Primary topic:
Non-communicable diseases (NCDs) and risk factors
Second topic:
Health promotion and wellbeing/healthy ageing/physical activity
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
University of British Columbia Behavioural Research Ethics Board (REB). CLSA protocol reviewed and approved by 13 REBs across Canada.
Provide the ethics approval number:
H22-01358
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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