Multimorbidity in the elderly in China based on the China Health and Retirement Longitudinal Study

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.

Fig 1. A web graph of associations between chronic diseases.

Fig 2. The result of local spatial autocorrelation of multimorbidity pattern.

(The source of map: http://bzdt.ch.mnr.gov.cn/browse.html?picId=%224o28b0625501ad13015501ad2bfc0240%22). A, the result of local spatial autocorrelation of [Asthma / Chronic lung diseases]; B, the result of local spatial autocorrelation of [Arthritis of rheumatism, Asthma / Chronic lung diseases]; C, the result of local spatial autocorrelation of [Dyslipidemia, Hypertension, Arthritis or rheumatism / Heart attack].