Study on the epidemiological trend of chronic disease comorbidities in middle-aged and elderly people of China
Objective To understand the epidemiological trends of chronic disease comorbidities and changes of their clustering model in middle-aged and elderly people of China,and provide the basis for the improvement of chronic disease comorbidities preventive and control measures and the optimization of medical resources allocation.Methods Data were from China Health and Retirement Longitudinal Study(CHARLS)2011 and 2020,12 149 middle-aged and elderly residents(≥45 years old)in 2011 were selected as the subjects,the investigation was performed with questionnaire(including general condition and prevalence of chronic diseases and comorbidities).Wilcoxon rank sum test,x2 test and multivariate logistic regression analysis were used to analyze the data,the used software was R 4.3.1.The stats package of the R language was used to implement the systematic clustering.The arules program package of the R language was used to mine the chronic disease comorbidity model.Results The mean age of the subjects in2011 was(57.7±8.6)years old.The median prevalence of 14 chronic diseases of subjects in 2011 was 1(P25-P75:0-2),and the median prevalence of subjects in 2020 increased to 2(P25-P75:1-4),P＜0.01.The comorbidity rate of subjects in 2020 was 63.0％,which was signifcantly higher than that(35.0％)in 2011(P＜0.01).Multivariate logistic regression analysis showed that at baseline investigation in 2011 or at follow-up in 2020,female(in 2011,OR=1.25;in 2020,OR=1.25),≥60 years old(in 2011,OR=1.56;in 2020,OR=1.51),smoking cessation(in 2011,OR=1.71;in 2020,OR=1.70)and not drinking alcohol(in 2011,OR=1.23;in 2020,OR=1.40)were related to higher risk of chronic disease comorbidities;living in the urban area(OR=1.18)at baseline investigation in 2011 was related to the higher risk of chronic disease comorbidities;drinking alcohol＜1 times per month(OR=1.38)at following up in 2020 was related to higher risk of chronic disease comorbidities;moderate or high physical activity levels(OR values were 0.86 or 0.76)and married(OR=0.88)at following up in 2020 were related to lower risk of chronic disease comorbidities(P＜0.05).The comorbidity models in 2011 were hypertension comorbidity(hypertension+dyslipidemia or heart disease or diabetes or stroke),arthritis or rheumatism comorbidity(arthritis or rheumatism+digestive disease or kidney disease)and chronic lung disease comorbidity(chronic lung disease+asthma);the comorbidity models in 2020 were hypertension comorbidity(hypertension+dyslipidemia or heart disease or diabetes or stroke),arthritis or rheumatism comorbidity(arthritis or rheumatism+digestive disease or kidney disease or liver disease or emotional and mental illness),chronic lung disease comorbidity(chronic lung disease+asthma),and digestive system disease comorbidity(digestive system disease+emotional and mental illness or liver disease or kidney disease).Conclusion The comorbidity rate in middle-aged and elderly people of China is higher and increases quickly.It should pay attension to females,residents ≥60 years old and people who quit smoking and do not drink alcohol to reduce the comorbidity risk.
Chronic disease comorbiditiesMiddle-aged and elderly peopleCluster analysisAssociation rules
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