Chinese General Practice ›› 2024, Vol. 27 ›› Issue (11): 1296-1302.DOI: 10.12114/j.issn.1007-9572.2023.0634

• Original Research • Previous Articles     Next Articles

Shifts in Chronic Disease and Comorbidity Patterns among Chinese Older Adults: an Analysis Based on the China Health and Retirement Longitudinal Study

  

  1. 1. Public Health Department/Community Management Department, Yuanhe Sub-district Health Center, Suzhou 215131, China
    2. Department of Endocrinology, Taiping Sub-district Health Center, Suzhou 215137, China
    3. Department of Endocrinology, Zhongshan Hospital Fudan University, Shanghai 200032, China
    4. Department of General Medicine, Zhongshan Hospital Fudan University, Shanghai 200032, China
  • Received:2023-09-11 Revised:2023-12-12 Published:2024-04-15 Online:2024-01-23
  • Contact: YU Peng, YU Ying
  • About author:
    XU Li and GE Jing are co-first authors

中国老年人慢性病及共病模式变化研究:基于中国健康与养老追踪调查数据

  

  1. 1.215131 江苏省苏州市相城区元和街道社区卫生服务中心公共卫生科(社管科)
    2.215137 江苏省苏州市相城区太平街道社区卫生服务中心内分泌科
    3.200032 上海市,复旦大学附属中山医院内分泌科
    4.200032 上海市,复旦大学附属中山医院全科医学科
  • 通讯作者: 于鹏, 虞莹
  • 作者简介:
    注:徐莉和葛晶为共同第一作者
    作者贡献:虞莹负责研究命题的提出、设计;葛晶和于鹏负责数据收集、采集、清洗和统计学分析、绘制图表等;徐莉负责论文起草;于鹏负责最终版本修订,对论文负责。
  • 基金资助:
    国家自然科学基金青年项目(82100392)

Abstract:

Background

The challenge of aging is becoming increasingly severe in China. Understanding the trends in chronic disease prevalence and comorbidity spectrum among the elderly is crucial for primary healthcare.

Objective

To analyze the prevalence and comorbidity patterns of chronic diseases among the elderly in China based on data from the China Health and Retirement Longitudinal Study (CHARLS) .

Methods

Participants aged ≥60 years from the 2011 (Wave 1) and 2015 (Wave 3) CHARLS dataset were selected. Their physical examination data and self-reported disease conditions, as well as the questionnaire data were extracted for descriptive statistical analysis of chronic disease and comorbidity prevalence, comparing changes over time. Latent class analysis (LCA) was employed to identify common clusters of comorbidities in the elderly and to assess their impact on daily living activities (evaluated using the Activities of Daily Living Scale, ADL) .

Results

A total of 7 290 individuals in 2011 and 9 845 in 2015, all aged≥60 years, were included in the study. The prevalence of chronic disease comorbidity increased from 85.96% in 2011 to 92.24% in 2015, indicating a significant rise (χ2=109.65, P<0.05). Except for pain and oral diseases, the prevalence of all other chronic diseases increased in 2015 (P<0.05). Combining self-reported diseases and laboratory results, the prevalence of overweight or obesity increased from 39.53% in 2011 to 42.88% in 2015 (χ2=35.12, P<0.01), and abdominal obesity from 45.37% to 47.99% (χ2=18.09, P<0.01). The prevalence of cardiovascular-metabolic disease comorbidity increased from 52.75% in 2011 to 60.49% in 2015 (χ2=64.39, P<0.01), becoming the primary form of chronic disease comorbidity in this population. The LCA categorized the elderly population into five comorbidity patterns in the elderly, with the "cardiovascular-metabolic + musculoskeletal diseases" pattern showing higher ADL scores compared to the "cardiovascular-metabolic diseases""musculoskeletal diseases""respiratory diseases" and "nonspecific comorbidities" patterns.

Conclusion

According to CHARLS data from 2011 and 2015, there is a high prevalence (85.96% in 2011 and 92.24% in 2015) and increasing trend in chronic disease comorbidity among Chinese individuals aged ≥60. Cardiovascular-metabolic comorbidity pattern is the most common, with many cases undetected, and the combination of cardiovascular-metabolic and musculoskeletal diseases has the most significant impact on the daily living abilities of the elderly.

Key words: Multiple chronic conditions, Comorbidity, Aged, Cardiovascular diseases, Metabolic diseases, Prevalence

摘要: 背景 我国老龄化问题日益严重,了解我国老年人慢性病患病率、共病患病谱的变化趋势,对基层卫生工作十分重要。目的 基于中国健康与养老追踪调查(CHARLS)数据,分析中国老年人慢性病患病情况及其共病模式。方法 选取CHARLS数据集中2011年(第1期)和2015年(第3期)年龄≥60岁的老年人为研究对象。提取其体检数据、调查问卷数据、自我报告的疾病情况,进行慢性病患病率、共病患病率的描述性统计分析,比较变化情况。采用潜类别分析(LCA),分析老年共病的常见集群,分析其对生活活动[采用日常生活活动能力量表(ADL)进行评价]的影响。结果 2011年7 290例、2015年9 845例≥60岁老年人被纳入本研究。慢性病共病患病率在2011年和2015年分别为85.96%、92.24%,2015年≥60岁老年人慢性病共病患病率较2011年升高(χ2=109.65、P<0.05)。除疼痛和口腔疾病外,2015年各种慢性病患病率均较2011年升高(P<0.05)。结合自我报告的疾病和实验室检查结果,发现超重或肥胖患病率从2011年的39.53%增至2015年的42.88%(χ2=35.12、P<0.01),腹型肥胖患病率从2011年的45.37%增至2015年的47.99%(χ2=18.09、P<0.01)。结合自我报告的疾病和实验室检查结果,可发现心血管代谢性疾病共病患病率从2011年的52.75%增至2015年的60.49%(χ2=64.39、P<0.01),且是该人群慢性病共病的主要形式。LCA将老年人群分为5类共病模式,其中"心血管代谢性疾病+骨关节疾病共病"模式的ADL评分高于"心血管代谢性疾病共病""骨关节疾病共病""呼吸系统疾病共病""非特异性共病"模式。结论 结合CHARLS数据库2011年和2015年数据来看,我国≥60岁的老年人慢性病共病率较高(2011年为85.96%,2015年为92.24%),且有持续增长的趋势。以心血管代谢性疾病共病最为常见,且存在大量未知晓的情况,心血管代谢性疾病+骨关节疾病共病对老年人日常活动能力的影响最大。

关键词: 慢性病共病, 共病现象, 老年人, 心血管疾病, 代谢疾病, 患病率