Journal article
Multimorbidity patterns and association with mortality in 0.5 million Chinese adults
- Abstract:
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Background:
Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.Methods:
We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.Results:
Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14 − 2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97 − 2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22 − 1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35 − 1.37) with every additional disease.Conclusion:
Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 186.9KB, Terms of use)
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- Publisher copy:
- 10.1097/cm9.0000000000001985
Authors
- Publisher:
- Wolters Kluwer
- Journal:
- Chinese Medical Journal More from this journal
- Volume:
- 135
- Issue:
- 6
- Pages:
- 648-657
- Publication date:
- 2022-02-20
- Acceptance date:
- 2021-12-08
- DOI:
- EISSN:
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2542-5641
- ISSN:
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0366-6999
- Pmid:
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35191418
- Language:
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English
- Keywords:
- Pubs id:
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1240834
- Local pid:
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pubs:1240834
- Deposit date:
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2022-10-14
- ARK identifier:
Terms of use
- Copyright holder:
- Chinese Medical Association
- Copyright date:
- 2022
- Rights statement:
- Copyright © 2022 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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