Abstract
This study aimed to investigate the spatial distribution and patterns of multimorbidity among the elderly in China. Data on the occurrence of 14 chronic diseases were collected for 9710 elderly participants in the 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Web graph, Apriori algorithm, age-adjusted Charlson comorbidity index (AAC), and Spatial autocorrelation were used to perform the multimorbidity analysis. The multimorbidity prevalence rate was estimated as 49.64% in the elderly in China. Three major multimorbidity patterns were identified: [Asthma/Chronic lungs diseases]: (Support (S) = 6.17%, Confidence (C) = 63.77%, Lift (L) = 5.15); [Asthma, Arthritis, or rheumatism/ Chronic lungs diseases]: (S = 3.12%, C = 64.03%, L = 5.17); [Dyslipidemia, Hypertension, Arthritis or rheumatism/Heart attack]: (S = 3.96%, C = 51.56, L = 2.69). Results of the AAC analysis showed that the more chronic diseases an elderly has, the lower is the 10-year survival rate (P < 0.001). Global spatial autocorrelation showed a positive spatial correlation distribution for the prevalence of the third multimorbidity pattern in China (P = 0.032). The status of chronic diseases and multimorbidity among the elderly with a spatial correlation is a significant health issue in China.
Highlights
Despite many unpredictable hygiene challenges can be life threatening and cause the population decline, such as climate change caused by the extreme weather, emerging infectious diseases such as SARS, COVID-19, and superbugs, the population is aging at an accelerating rate and most people will live beyond the age of 60, with far-reaching impact on health systems, health workers, and health budget in China and around the world.Aging is often accompanied by multimorbidity or contemporaneous occurrence of a variety of chronic diseases [1]
Results show that the prevalence of multimorbidity patterns for [Dyslipidemia, Hypertension, Arthritis or rheumatism/Heart attack] followed a distinctly positive correlation distribution in China, while the prevalence of the other two multimorbidity patterns showed random distributions without spatial correlation distribution in China (S3 Table)
The overall prevalence of most chronic diseases is higher in the urban areas, while the prevalence of specific conditions such as stomach or other digestive diseases, arthritis or rheumatism, asthma, and emotional/nervous disorders or psychiatric problems is higher in the rural areas
Summary
Despite many unpredictable hygiene challenges can be life threatening and cause the population decline, such as climate change caused by the extreme weather, emerging infectious diseases such as SARS, COVID-19, and superbugs, the population is aging at an accelerating rate and most people will live beyond the age of 60, with far-reaching impact on health systems, health workers, and health budget in China and around the world.Aging is often accompanied by multimorbidity or contemporaneous occurrence of a variety of chronic diseases [1]. The World Health Organization (WHO) defined multimorbidity as the coexistence of two or more chronic conditions in the same individual. Various studies have reported that elderly patients with multimorbidity are at higher risk of death, longer. Multimorbidity in the elderly in China hospital stay, poorer quality of life, and poorer physical function than those with a single chronic disease [2,3,4,5]. The burden caused by multimorbidity is multifaceted, and impacts medical and health resources, families, and caregivers [6]. Barnett K et al [7] reported that patients with multimorbidity had lower functional status, lower quality of life, and poor health outcomes, along with higher rates of outpatient visits and hospitalizations than patients with a single chronic disease
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