Abstract
To explore the multimorbidity prevalence and patterns among middle-aged and older adults from China. Data on thirteen chronic diseases were collected from 2,097,150 participants aged over 45 years between January 1st 2011 and December 31st 2015 from Beijing Medical Claim Data for Employees. Association rule mining and hierarchical cluster analysis were applied to assess multimorbidity patterns. Multimorbidity prevalence was 51.6% and 81.3% in the middle-aged and older groups, respectively. The most prevalent disease pair was that of osteoarthritis and rheumatoid arthritis (OARA) with hypertension (HT) (middle-aged: 22.5%; older: 41.8%). Ischaemic heart disease (IHD), HT, and OARA constituted the most common triad combination (middle-aged: 11.0%; older: 31.2%). Among the middle-aged group, the strongest associations were found in a combination of cerebrovascular disease (CBD), OARA, and HT with IHD in males (lift = 3.49), and CBD, OARA, and COPD with IHD in females (lift = 3.24). Among older patients, glaucoma and cataracts in females (lift = 2.95), and IHD, OARA, and glaucoma combined with cataracts in males (lift = 2.45) were observed. Visual impairment clusters, a mixed cluster of OARA, IHD, COPD, and cardiometabolic clusters were detected. Multimorbidity is prevalent among middle-aged and older Chinese individuals. The observations of multimorbidity patterns have implications for improving preventive care and developing appropriate guidelines for morbidity treatment.
Highlights
Multimorbidity, commonly defined as the cooccurrence of two or more chronic diseases, has gained increasing attention as a prominent public health issue worldwide [1]
The overall proportion of people with multimorbidity increased from 51.6%
Females had a higher prevalence than males for each age group
Summary
Multimorbidity, commonly defined as the cooccurrence of two or more chronic diseases, has gained increasing attention as a prominent public health issue worldwide [1]. Multimorbidity has been associated with poorer health outcomes including greater risk of disability and mortality among older populations [2]. It complicates treatment and health care plans and increases the risk of psychiatric and somatic complications, leading to higher healthcare expenditures and resource utilization [3,4]. A large body of literature has reported multimorbidity prevalence and patterns worldwide. It was reported that the prevalence of multimorbidity ranged from 45% to 72% among older adults aged 50 years and over in nine countries [5] and ranged from 24% to 83% among those aged 60 years and older in South Asia [6]. Studies have observed different multimorbidity patterns, such as cardiometabolic patterns, mental health patterns, and musculoskeletal
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