Abstract
We aimed to identify prevalent somatic-mental multimorbidity (SMM) and examine its prospective association with disability among a nationally representative sample. A total of 6728 participants aged 60 years and older in the China Health and Retirement Longitudinal Study were included. A total of 14 somatic or mental conditions were assessed in 2013. SMM was defined as any combination of two or more conditions in which at least one condition was somatic and at least one condition was mental. Disability risk was measured using the combined Activities of Daily Living (ADL)-Instrumental Activities of Daily Living (IADL) index (range 0–11; higher index indicates higher disability) in 2013 and 2015. Overall, the prevalence of SMM was 35.7% (95% confidence interval (CI): 34.1%-37.3%) in 2013. After adjustment for sociodemographic characteristics, lifestyles and baseline ADL-IADL index, over a maximum follow-up period of 2 years, SMM was associated with a 2.61 (95% CI: 2.12-3.22)-fold increase in ADL-IADL disability risk compared with that of healthy participants. In conclusion, SMM was prevalent in older Chinese adults, and it was associated with a higher risk of prospective disability.
Highlights
China, a large middle-income country, has the world’s largest aging population [1, 2]
After adjustment for sociodemographic characteristics, lifestyles and baseline Activities of Daily Living (ADL)-Instrumental Activities of Daily Living (IADL) index, over a maximum follow-up period of 2 years, somatic-mental multimorbidity (SMM) was associated with a 2.61-fold increase in ADL-IADL disability risk compared with that of healthy participants
SMM was prevalent in older Chinese adults, and it was associated with a higher risk of prospective disability
Summary
A large middle-income country, has the world’s largest aging population [1, 2]. Stroke, ischemic heart disease, and chronic obstructive pulmonary disease are the top three causes of years of life lost in China [4]. Somatic multimorbidity (defined as two or more chronic diseases [5]) is common and prevalent among older Chinese adults. The approximate prevalence of multimorbidity has been reported to be between 10% and 90% in different study populations in China [6,7,8,9]. Numerous epidemiologic studies have reported that multimorbidity is associated with reduced quality of life [10], compromised self-rated health [11], depressive symptoms [12], cognitive impairment [13], disability [14], and all-cause mortality [15]. Multimorbidity leads to more complex economic and healthcare challenges [6]
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