Background People with multiple long term conditions (MLTC) face health and social care challenges. This study aimed to classify people by MLTC and Social Care Need (SCN) into distinct clusters and quantify the association between derived clusters and care outcomes. Methods A cohort study was conducted using the English Longitudinal Study of Ageing (ELSA), including people with up to ten MLTC. Self-reported SCN was assessed through 13 measures of difficulty with activities of daily living, ten measures of mobility difficulties, and whether health status was limiting earning capability. Latent class analysis was performed to identify clusters. Multivariate logistic regression quantified associations between derived MLTC/SCN clusters, all-cause mortality, and nursing home admission. Results The cohort included 9171 people at baseline with a mean age of 66.3 years; 44.5% were males. Nearly 78.8% had two or more MLTC, the most frequent being hypertension, arthritis and cardiovascular disease. We identified five distinct clusters classified as high SCN/MLTC through to low SCN/MLTC clusters. The high SCN/MLTC included mainly women aged 70 to 79 years who were white and educated to the upper secondary level. This cluster was significantly associated with higher nursing home admission (OR = 8.97; 95% CI: 4.36 to 18.45). We found no association between clusters and all-cause mortality. Conclusions This results in five clusters with distinct characteristics that permit the identification of high risk groups who are more likely to have worse health outcomes, including nursing home admission. This can inform targeted preventative action to where it is most needed amongst those with MLTC.

The authors have declared no competing interest.

This study is independent research funded by the National Institute for Health Research (Artificial Intelligence for Multiple Long-Term Conditions (AIM), (NIHR202637). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was granted by the University of Southampton Faculty of Medicine Research Committee (67953).

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ELSA data were available through the UK Data Archive and are widely available to access in this way; as such, our study data will not be made available for access.