Prevalence and Patterns of Chronic Disease Pairs and Multimorbidity among Older Chinese Adults Living in a Rural Area

PLoS One. 2015 Sep 22;10(9):e0138521. doi: 10.1371/journal.pone.0138521. eCollection 2015.

Abstract

Background: The burden of chronic diseases in China is substantial now. Data on patterns of chronic diseases and multimorbidity among older adults, especially among those living in rural areas, are sparse.

Objective: We aim to investigate the prevalence and patterns of chronic disease pairs and multimorbidity in elderly people living in rural China.

Methods: This population-based study included 1480 adults aged 60 years and over (mean age 68.5 years, 59.4% women) living in a rural community. Data were derived from the Confucius Hometown Aging Project in Shandong, China (June 2010-July 2011). Chronic diseases were diagnosed through face-to-face interviews, clinical examinations, and laboratory tests. Patterns of chronic disease pairs and multimorbidity were explored using logistic regression and exploratory factor analyses.

Results: The prevalence of individual chronic diseases ranged from 3.0% for tumor to 76.4% for hypertension, and each disease was often accompanied with three or more other chronic diseases. The observed prevalence of pairs of chronic conditions exceeded the expected prevalence for several conditions, such as cardiovascular diseases and metabolic disorders, as well as pulmonary diseases and degenerative disorders. Chronic multimorbidity (≥2 chronic diseases) affected more than 90% of subjects, and two patterns of chronic multimorbidity were identified: cardiopulmonary-mental-degenerative disorder pattern (overall prevalence, 58.2%), and cerebrovascular-metabolic disorder pattern (62.6%). Prevalence of the cardiopulmonary-mental-degenerative disorder pattern increased with age, and was higher in men than women; whereas prevalence of the cerebrovascular-metabolic disorder pattern was higher in women than in men but did not vary by age.

Conclusion: Chronic multimorbidity was highly prevalent among older Chinese adults living in rural areas, and there were specific patterns of the co-occurrence of chronic diseases. Effort is needed to identify possible preventative strategies based on the potential clustering of chronic diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asian People
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology*
  • China / epidemiology
  • Chronic Disease
  • Comorbidity
  • Demography
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Interviews as Topic
  • Logistic Models
  • Male
  • Metabolic Diseases / complications
  • Metabolic Diseases / epidemiology*
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / epidemiology*
  • Prevalence
  • Rural Population

Grants and funding

The Confucius Hometown Aging Project (CHAP) was supported in part by grants from the Department of Science and Technology (2008GG30002058), the Department of Health (2009-067), the Natural Science Foundation (ZR2010HL031) in Shandong, China, and by the Young Scholar Grant for Strategic Research in Epidemiology at Karolinska Institutet, Stockholm, Sweden. CQ received grants from the Swedish Research Council (K2012-99X-21967-01-3), the Swedish Research Council for Health, Working Life and Welfare (2014-1382), and Karolinska Institutet, Stockholm, Sweden. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.