With the acceleration of population aging, chronic disease comorbidities have become a major public health problem threatening the health of the elderly. There is a close correlation between chronic disease comorbidity and activity of daily living (ADL). However, there are few studies on the influence of chronic disease comorbidity and comorbidity pattern on ADL.

To understand the impact of chronic disease comorbidity on ADL, to provide a reference for improving the quality of life of the elderly.

From June to July 2022, a multi-stage stratified random cluster sampling method was used to conduct a face-to-face household survey among 20 821 residents in 4 counties of Ningxia Hui Autonomous Region, including demographic characteristics, chronic diseases, and ADL impairment. In this study, 4 362 elderly people (≥60 years) were included as subjects. Potential category analysis was used to determine comorbidity patterns, and Logistic regression was used to analyze the effects of chronic disease comorbidity and different comorbidity patterns on activities of daily living.

The prevalence of chronic diseases among the elderly included was 62.52% (2 727/4 362), the prevalence of comorbidities was 23.75% (1 036/4 362), the ADL damage rate was 18.36% (801/4 362). Five comorbidity patterns were identified based on the latent category analysis, namely the coronary heart disease comorbidity group, the rheumatoid arthritis comorbidity group, the diabetes comorbidity group, the hypertension comorbidity group, and the multisystem disease comorbidity group. Adjusting for factors such as gender, age, educational level, marital status, occupation, annual per capita household income, smoking, alcohol consumption, exercise status, and self-rated health status, elderly people with comorbidity had 1.909 times (95%CI=1.581-2.305, P<0.05) risk of impaired ADL than those without comorbidity, older adults in the rheumatoid arthritis comorbidity group had a higher risk of impaired ADL than those in the coronary heart disease comorbidity group [OR (95%CI) =1.834 (1.245-2.701), P<0.05] .

Older adults with chronic comorbidities have a higher risk of ADL impairment than older adults without chronic comorbidities. There are differences in the risk of ADL impairment among the elderly with different comorbidity patterns of chronic diseases. The risk of ADL impairment in the elderly in the comorbidity group of rheumatoid arthritis is higher than that in the comorbidity group of coronary heart disease. Therefore, there is an urgent need to pay more attention to elderly people with chronic disease comorbidities, appropriate measures should be taken to improve their health and improve their quality of life.

随着人口老龄化进程的加速，慢性病共病已成为威胁老年人健康的主要公共卫生问题。慢性病共病与日常生活活动能力（ADL）之间存在密切关联，但关于慢性病共病及共病模式对ADL影响的研究相对缺乏。

了解宁夏回族自治区南部山区农村老年人慢性病共病对ADL的影响，为提高老年人的生命质量提供参考依据。

于2022年6—7月，采用多阶段分层随机整群抽样法对宁夏回族自治区4个县的20 821名居民进行"面对面"入户调查，调查内容包括人口学特征、慢性病患病及ADL受损情况等。本研究以4 362名≥60岁老年人为研究对象，采用潜在类别分析确定老年人的慢性病共病模式，采用多因素Logistic回归分析探讨慢性病共病及不同共病模式对老年人ADL的影响。

4 362名老年人的慢性病患病率为62.52%（2 727/4 362），慢性病共病发生率为23.75%（1 036/4 362），ADL受损发生率为18.36%（801/4 362）。基于潜在类别分析确定了5种共病模式，分别是冠心病共病组、类风湿关节炎共病组、糖尿病共病组、高血压共病组、多系统疾病共病组。多因素Logistic回归分析结果显示，调整了性别、年龄、文化程度、婚姻状况、职业类型、家庭人均年收入、吸烟情况、饮酒情况、锻炼情况、自评健康状况因素后，慢性病共病老年人的ADL受损风险是非慢性病共病老年人的1.909倍（95%CI=1.581~2.305，P<0.05），类风湿性关节炎共病组老年人的ADL受损风险是高血压共病组老年人的1.834倍（95%CI=1.245~2.701，P<0.05）。

慢性病共病老年人较非慢性病共病老年人的ADL受损风险更高，不同慢性病共病模式老年人的ADL受损风险存在差异，类风湿关节炎共病组老年人的ADL受损风险高于冠心病共病组老年人。应加强对老年慢性病共病患者的关注，采取适宜措施改善其健康状况、提升其生活质量。