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

Rui Wang,Yajun Liang,Chuanzhu Cai,Chengxuan Qiu,Hui Jiang,Edwin C K Tan,Aiqin Song,Zhongrui Yan,Giuseppe Sergi

doi:10.1371/journal.pone.0138521

Abstract

BackgroundThe 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.ObjectiveWe aim to investigate the prevalence and patterns of chronic disease pairs and multimorbidity in elderly people living in rural China.MethodsThis 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.ResultsThe 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.ConclusionChronic 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.

Highlights

Chronic non-communicable diseases have replaced infectious diseases to become a major public health burden [1]
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

Summary

Introduction

Chronic non-communicable diseases have replaced infectious diseases to become a major public health burden [1]. Unlike most western countries that have had this transition at a slower pace, China has experienced this shift only in a few decades [2,3], which has caused a rapid increase in chronic disease burden. The proportion of all-cause mortality attributable to chronic disease in China was 58.2% in 1973–1975, and this number increased to 73.8% in 1991 [2]. China is facing a substantial burden of chronic multimorbidity in the coming decades owing to a rapid increase in the aging population. 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

Methods

Results

Conclusion