The estimation of the prevalence of multimorbidity and identification of high-risk populations can directly affect the corresponding rational allocation of public health resources.
To comprehensively describe the prevalence trends and population characteristics of multimorbidity among residents in mainland China from 1998-2019 through Meta-analysis.
The databases including Web of Science, PubMed, CNKI, Wanfang Data Knowledge Service Platform and VIP were searched for journal literature relevant to the prevalence of multimorbidity in mainland China from inception to 2022-04-30. Data extraction and quality evaluation were performed on the literature and meta-analysis was performed using Stata 14.0 software. The pooled prevalence of multimorbidity was calculated by using random effects model, and subgroup analysis of the prevalence of multimorbidity was conducted based on survey time (before 2004, 2004-2013, since 2014), gender, region (urban, rural), geographical area (east, central, west, northeast), education level (uneducated, primary school, secondary school and above), marital status (married, others), and research quality (low, medium, high) .
A total of 123 papers were included into analysis with a total sample size of 7 714 313 cases. There was significant heterogeneity among studies (I2=100.0%, P<0.001), and the prevalence of multimorbidity was 36.3%〔95%CI (32.8%, 39.9%) 〕. Meta-linear regression model showed a non-linear increasing trend in the prevalence of multimorbidity from 1998 to 2019〔β=0.013, 95%CI (0.006, 0.019) 〕. The results of the subgroup analysis showed that the prevalence of multimorbidity was higher since 2014〔40.4%, 95%CI (33.0%, 47.8%) 〕 than before 2004〔14.5%, 95%CI (12.5%, 16.5%) 〕 and 2004-2013〔35.2%, 95%CI (32.2%, 38.2%) 〕 (P<0.001) ; the prevalence of multimorbidity was higher among those aged 60-79 years〔38.1%, 95%CI (34.6%, 41.5%) 〕 than those aged ≥80 years〔36.6%, 95%CI (32.5%, 40.8%) 〕, 40-59 years〔27.7%, 95%CI (24.4%, 31.1%) 〕, and <40 years〔10.6%, 95%CI (9.0%, 12.3%) 〕 (P<0.001). There was no significant difference in the subgroup analysis of gender, education level, marital status, region, geographical area, type of chronic disease, quality of research, and the comparison of the prevalence of multimorbidity (P>0.05) .
The prevalence of multimorbidity among residents in mainland China was 36.3% from 1998 to 2019 with a rising trend and significant differences in age, therefore, attention should be paid to the early screening of high-risk population, active and effective strategies for prevention and control should be adopted.
With the aging and longer survival of the population, comorbid chronic diseases is increasingly common. The variety and complexity of diseases pose challenges to the health management of the elderly. There is a relative lack of multimorbidity pattern researches in China, which are necessary issues for research.
To investigate the patterns of coexistence of common multiple chronic conditions among the elderly in China, in order to help policymakers, researchers, and clinicians better understand the current status of multimorbidity among Chinese elderly.
Data on the demographic characteristics and health status of 14 chronic diseases were extracted from the respondents aged 60 years and above in the China Health and Retirement Longitudinal Study (CHARLS) 2018, association rules, cluster analysis, principal component analysis, latent class analysis were used to explore the multimorbidity patterns of Chinese elderly, and the results of different methods were compared.
The data from a total of 10 800 respondents were eventually included, there were differences among the patterns obtained by four methods. However, the consistent multimorbidity patterns were identified: hypertension, diabetes or elevated blood glucose, dyslipidemia; chronic lung disease and asthma; arthritis or rheumatism, stomach diseases or digestive diseases; stroke, memory-related diseases.
The consistent patterns obtained by different methods contain chronic diseases with significant relationships of etiologies. The reasons of differences in results are complex etiologic relationships and different method principles.
In the context of aging society in China, the prevalence of Alzheimer's disease increases and multimorbidity becomes more common with years. However, the extensive investigations of Alzheimer's disease in Hunan province have not been reported adequately and the multimorbidity relationship between relevant diseases remains unclear.
To completely understand the prevalence of Alzheimer's disease in residents aged 65 or above in Hunan and analyze its multimorbidity relationships with 11 common chronic diseases.
The residents aged 65 years and above in 30 districts (counties), 60 streets (townships), and 180 neighborhood (village) committees in Hunan Province were randomly selected between April and May 2021 by using stratified multistage sampling method. Alzheimer's disease was diagnosed by a neurologist or psychiatrist using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), after using the Community Screening Interview for Dementia (CSI-D) or the 8-item ascertain dementia (AD8) as the screening tools. In addition, all respondents were investigated for the prevalence of hypertension, cerebrovascular disease, ischemic heart disease, rheumatoid arthritis, intervertebral disc disease, diabetes, gastroenteritis, chronic obstructive pulmonary disease, calculous cholecystitis, peptic ulcer and cancer.
A total of 5 979 residents were sampled, 5 616 of them completed the examinations and 785 (13.98%) were diagnosed with Alzheimer's disease. There were significant differences in the prevalence of Alzheimer's disease among respondents with different regions, gender, age, smoking history and presence of other chronic diseases (P<0.05). The total number of patients with other chronic diseases among all respondents was 5 606, with the top five diseases of hypertension〔2 205 (39.33%) 〕, intervertebral disc disease〔553 (9.86%) 〕, diabetes 〔526 (9.38%) 〕, cerebrovascular disease〔492 (8.78%) 〕, and ischemic heart disease〔467 (8.33%) 〕. The top five diseases in the dementia patients were hypertension〔325 (41.40%) 〕, cerebrovascular disease〔111 (14.14%) 〕, ischemic heart disease〔91 (11.59%) 〕, rheumatoid arthritis 〔89 (11.33%) 〕, and intervertebral disc disease〔81 (10.31%) 〕. The prevalence of dementia in patients with no chronic disease, with 1, 2, 3 or more types of other chronic diseases was 11.46% (214/1 867), 13.66% (309/2 262), 17.50% (176/1 006), and 18.26% (86/471), respectively. There were statistically significant differences in the prevalence of Alzheimer's disease between the subjects with and without gastroenteritis, rheumatoid arthritis, cerebrovascular disease, chronic obstructive pulmonary disease, and ischemic heart disease, respectively (P<0.05). Binary Logistic regression analysis showed that living in rural areas〔OR=2.048, 95%CI (1.655, 2.536) 〕, female〔OR=1.388, 95%CI (1.163, 1.655) 〕, aging〔OR=1.348, 95%CI (1.270, 1.431) 〕, and suffering from other chronic diseases〔OR=1.195, 95%CI (1.101, 1.297) 〕 were risk factors for the development of Alzheimer's disease in residents aged 65 years and above (P<0.05). The investigation results of timely medication taking in the patients with Alzheimer's disease showed that 12.79% (99/774) reported difficulties, 6.59% (51/774) needed help, and 2.97% (23/774) were unable to complete independently.
The prevalence of Alzheimer's disease in residents aged 65 years and above in Hunan Province increases with the number of other chronic diseases and correlates with multiple diseases. Great attention should be paid on the self-care ability and family care burden of Alzheimer's disease by society. The prevalence and multimorbidity of Alzheimer's disease were basically grasped by the investigation, in order to provide an objective basis for the formulation of policies on its prevention and treatment.
In China, as population aging quickens, multimorbidity has become a major public health problem threatening the health of elderly people. Multimorbidity has a negative impact on mental health, but there is a lack of research on its association with anxiety symptoms in elderly people.
To investigate the influence of multimorbidity on anxiety symptoms among Chinese elderly people, so as to provide references for improving mental health for older people with multimorbidity.
We selected 6 854 older adults (≥65 years old) from the participants of the Chinese Longitudinal Healthy Longevity Survey 2018 from December 2022 to February 2023. The 7-item Generalized Anxiety Disorder Scale was used to assess symptoms of anxiety. Multimorbidity was defined as having two or more coexisting chronic conditions, while non-multimorbidity was defined as having only one or no chronic condition. Propensity score matching (PSM) was used tomatch individuals with and without multimorbidity. The association of multimorbidity with anxiety symptoms was analyzed by univariate and multivariate Logistic regression analyses.
Among the 6 854 cases, the prevalence of multimorbidity and anxiety symptoms was 38.04% (2 607/6 854), and 10.53% (722/6 854), respectively. There were 4 247 cases (61.96%) without multimorbidity, of whom 2 102 (30.67%) had no chronic disease, and 2 145 (31.29%) had one chronic disease. A total of 2 282 pairs of multimorbidity and non-multimorbidity (4 564 cases altogether) were obtained after matching. Multivariate Logistic regression analysis showed that multimorbidity was the risk factor of anxiety symptoms〔OR=1.399, 95%CI (1.166, 1.679), P<0.001〕. Besides that, gender, ability to perform activities of daily living and receiving a pension were also related to anxiety symptoms (P<0.05). Five hundred and twenty-two pairs (1 044 cases altogether) were obtained after matching the subjects with multimorbidity and those with one chronic disease using PSM, and the analysis found that those with one chronic disease had higher prevalence of anxiety symptoms〔64.76% (215/332) vs 43.12% (307/712) 〕 (P<0.001) .
Compared with their counterparts without multimorbidity, elderly people with multimorbidity had higher risk of anxiety symptoms, so more attentions should be paid to the mental health of these people.
