Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

Abstract

BackgroundMultimorbidity presents an enormous problem to societal and healthcare utilization under the context of aging population in low- and middle-income countries (LMICs). Currently, systematic studies on the profile of multimorbidity and its characteristics among Chinese elderly are lacking. We described the temporal and spatial trends in the prevalence of multimorbidity and explored chronological changes of comorbidity patterns in a large elderly population survey.MethodsData were extracted from the Chinese Longitudinal Healthy Longevity Study (CLHLS) conducted between 1998 and 2018 in a random selection of half of the counties and city districts. All the elderly aged 65 and older were included in the survey of eight waves. We used 13 investigated chronic diseases to measure the prevalence of multimorbidity by means of geography, subpopulation, and chronological changes. The patterns of multimorbidity were assessed by computing the value of relative risk (RR indicates the likelihood of certain diseases to be associated with multimorbidity) and the observed-to-expected ratio (O/E indicates the likelihood of the coexistence of a multimorbidity combination).ResultsFrom 1998 to 2018, the prevalence of multimorbidity went from 15.60 to 30.76%, increasing in the fluctuation across the survey of eight waves (pfor trend = 0.020). Increasing trends were observed similarly in a different gender group (pmale = 0.009; pfemale = 0.004) and age groups among female participants (p~80 = 0.009; p81−90 = 0.004; p91−100 = 0.035; p101~ = 0.018). The gap in the prevalence of multimorbidity between the north and the south was getting narrow across the survey of eight waves. Hypertension was the highest prevalent chronic condition while diabetes was most likely to coexist with other chronic conditions in the CLHLS survey. The most frequently occurring clusters were hypertension and heart disease, hypertension and cataract, and hypertension and chronic lung disease. And, the cancer, TB, and Parkinson's disease cluster took the domination of O/E rankings over time, which had a higher probability of coexistence in all the multimorbidity combinations.ConclusionsThe prevalence of multimorbidity has been increasing nationwide, and more attention should be paid to a rapid growth in the southern part of China. It demands the effective diagnosis and treatment adopted to the highly prevalent comorbidities, and strategies and measures were adjusted to strongly relevant clusters.

Waist-to-calf circumstance ratio and cognitive function among Chinese older adults: Mediating roles of physical performance and social activity

“…The current study confirmed that a high WCR is significantly associated with reduced cognitive function among elderly individuals, which is consistent with previous studies showing that SO or a higher adiposity-to-muscle ratio negatively impacts cognitive function in older adults (Gao et al, 2015(Gao et al, , 2020Ribeiro Santos et al, 2020;Brewster et al, 2021;Chen et al, 2021). This finding suggested that the combination of sarcopenia and obesity could generate a synergetic effect on cognitive impairment rather than a simple superposition, but the mechanism underlying this effect is unclear (Gao et al, 2020).…”

“…Due to the lack of a uniform definition for SO and different study populations, its reported prevalence estimates range from 2.75% to 20% or more (Chang et al, 2015). According to some previous reports, the prevalence of SO in Chinese community-dwelling older adults was estimated at 6.0-25.0% (Chang et al, 2016;Chen et al, 2021;Cheng et al, 2022). SO is associated with poor health outcomes including frailty, disability (Choe et al, 2018), fractures, falls (Chou et al, 2022), cancer (Daviglus et al, 2010), cardiometabolic diseases (Donini et al, 2020), chronic kidney disease (Dye et al, 2017), and increased mortality (Espeland et al, 2022).…”

“…Those who suffer from this geriatric syndrome are at risk of synergistic complications that can eventually result in long-term functional decline. Of importance, studies have shown associations between SO and impaired mental health (Etgen et al, 2011 ; Chen et al, 2021 ; Fan et al, 2021 ), including depression, dementia, and cognitive decline, as well as decreased psychological wellbeing. Considering these associations, researchers and policy experts are increasingly interested in identifying interventions that could improve health outcomes for older adults with SO.…”

The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships

“…Detailed variable codes are presented in Supplementary Table S5 . For the health status, the CLHLS adopted a list of 13 chronic diseases or conditions (e.g., hypertension, diabetes, heart diseases, stroke, cancers, Parkinson’s disease) to measure comorbidity; an individual was considered to have physical comorbidities (yes or no) if he or she self-reported more than two of these thirteen diseases or conditions at the time of the surveys ( 35 , 36 ).…”

Direct Medical Costs of Parkinson’s Disease in Southern China: A Cross-Sectional Study Based on Health Insurance Claims Data in Guangzhou City

“…LOS was classified into three groups: less than 15 days, 15–30 days and 30 days and longer. Presence of comorbidities was measured by binary variables indicating whether individuals had the following doctor-diagnosed major chronic diseases: hypertension [ 50 , 51 , 52 ], diabetes [ 50 , 52 ], coronary heart disease [ 50 ], Alzheimer’s disease, schizophrenia [ 53 , 54 ] and mood disorders [ 52 , 55 ]. The detailed measures of variables are shown in Table 3 .…”