Background Alexithymia is common among older adults, particularly those with multiple chronic conditions; however, its heterogeneity in empty-nest populations remains insufficiently explored. This study aimed to identify latent subgroups of alexithymia and examine their characteristics among elderly empty-nesters with multiple chronic diseases. Methods A total of 561 empty-nest older adults with at least two chronic conditions were recruited from six cities in Jiangsu Province, China (November 2022–March 2024). Alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20), and latent class analysis was conducted to identify subgroups. Results The total alexithymia score of the empty-nest elderly with multiple chronic diseases was (57.31 ± 9.80) points. Alexithymia can be divided into four potential subgroups: the Emotional Repression Group (39.2%), the Extraverted Thinking Group (11.6%), the Emotional Ambiguity Group (10.2%), and the Good Emotional Adaptation Group (39.0%). Multiple chronic diseases among empty-nesters in different alexithymia subgroups were statistically significant in terms of age group, average monthly household income, whether an acute event had occurred within the past year, and perception of their own health. Conclusion Alexithymia in elderly empty-nesters with multiple chronic diseases shows distinct patterns. Medical staff should focus on the Emotional Ambiguity and Emotional Repression groups and provide targeted interventions for each type.
Shang et al. (2026) studied this question.