The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China.
BMC Geriatr. 2023 Jul 24;23(1):455. doi: 10.1186/s12877-023-04159-8.
Multiple chronic conditions (MCC) refer to the presence of two or more chronic diseases. The incidence of MCC is higher in older people, and increases with age. Studies have shown an association between MCC and increased adverse outcome, as well as the higher mortality, decline of physical function, and poor quality of life in older populations. Herein, for the first time we provide the data of ethnic and geographic variations in the prevalence of MCC among community-dwelling older people in Xinjiang, China.
A multilevel random sampling method was employed to perform an epidemiological survey in community-dwelling older adults in southern, northern, and eastern Xinjiang between January 2019 to December 2019. In total, 87,000 participants volunteered, with a response rate of 96.67%; 490 participants with incomplete data were excluded and data from 86,510 participants were analyzed.
Our analysis demonstrated that hypertension (51.5%), obesity (27.0%), diabetes (16.9%), heart disease (8.2%), and anxiety/depression (4.5%) were the five main chronic diseases in Xinjiang. The prevalence of MCC in the population surveyed was 33.4% (95%CI, 33.1-33.7). The prevalence in females was 36.6% (95%CI, 36.1-37), which was higher than that in male (30%,95%CI, 29.5-30.4). The prevalence of MCC in older people aged 60-69, 70-79, 80-89, and ≥ 90 years was 32.7% (95%CI, 32.2-33.3), 34.3% (95%CI, 33.9-34.7), 32.5% (95% CI, 31.7-33.3), and 25.9% (95% CI, 23.5-28.3) respectively. As far as the ethnic group was concerned, the prevalence of MCC in Uygur, Han, Kazak, Hui, and Mongolian was 31.3% (95%CI, 30.9-31.7), 34.4% (95%CI, 33.9-35), 40.4% (95%CI, 39.1-41.8), 40.8% (95%CI, 38.9-42.7), 44.4% (95%CI, 38.1-50.6), respectively. The prevalence of MCC was 32.8% (95%CI, 32.1-33.5), 31.7% (95%CI, 31.2-32.1), 36.0% (95%CI, 35.3-36.7) and 39.2% (95%CI, 38.1-40.3) among uneducated, educated for 1-6, 7-9, and more than 10 years. After adjusting for age, sex, smoking, alcohol consumption, and education by level, the binary logistic analysis showed that, compared with eastern Xinjiang, the risk of MCC in the southern area was increased (odds ratio [OR], 1.418; 95% confidence interval [CI], 1.367-1.471), and it was relatively higher in northern Xinjiang (OR, 2.021; 95% CI, 1.944-2.102). Compared with Uygur, Han, Kazakh, Hui and Mongolian had an increased risk of MCC, which was (OR, 1.075; 95% CI, 1.040-1.111), (OR, 1.414; 95% CI, 1.332-1.501), (OR, 1.515; 95% CI, 1.396-1.644), (OR, 1.566; 95% CI, 1.216-2.017), respectively.
There are ethnic and geographic variations in multiple chronic conditions among community-dwelling older people in Xinjiang. The older adults living in northern and southern Xinjiang and Han, Kazakh, Mongolian and Hui older adults have a higher risk of MCC.
多种慢性疾病（MCC）是指存在两种或多种慢性疾病。MCC 在老年人中发病率较高，且随年龄增长而增加。研究表明，MCC 与不良预后以及老年人更高的死亡率、身体功能下降和生活质量降低有关。在此，我们首次提供了中国新疆社区老年人中多种慢性疾病流行的民族和地域差异的数据。
采用多水平随机抽样方法，于 2019 年 1 月至 12 月在新疆南部、北部和东部社区老年人中进行了一项流行病学调查。共有 87000 人自愿参加，应答率为 96.67%；排除了 490 名数据不完整的参与者，对 86510 名参与者的数据进行了分析。
我们的分析表明，高血压（51.5%）、肥胖症（27.0%）、糖尿病（16.9%）、心脏病（8.2%）和焦虑/抑郁（4.5%）是新疆的五种主要慢性疾病。调查人群中 MCC 的患病率为 33.4%（95%CI，33.1-33.7）。女性患病率为 36.6%（95%CI，36.1-37），高于男性（30%，95%CI，29.5-30.4）。60-69 岁、70-79 岁、80-89 岁和≥90 岁老年人的 MCC 患病率分别为 32.7%（95%CI，32.2-33.3）、34.3%（95%CI，33.9-34.7）、32.5%（95%CI，31.7-33.3）和 25.9%（95%CI，23.5-28.3）。就民族而言，维吾尔族、汉族、哈萨克族、回族和蒙古族的 MCC 患病率分别为 31.3%（95%CI，30.9-31.7）、34.4%（95%CI，33.9-35）、40.4%（95%CI，39.1-41.8）、40.8%（95%CI，38.9-42.7）、44.4%（95%CI，38.1-50.6）。MCC 的患病率分别为 32.8%（95%CI，32.1-33.5）、31.7%（95%CI，31.2-32.1）、36.0%（95%CI，35.3-36.7）和 39.2%（95%CI，38.1-40.3），在未受教育、受教育 1-6 年、受教育 7-9 年和受教育 10 年以上的人群中。经年龄、性别、吸烟、饮酒和教育程度分层调整后，二元逻辑分析显示，与新疆东部相比，南部地区 MCC 的发病风险增加（比值比[OR]，1.418；95%置信区间[CI]，1.367-1.471），而新疆北部的风险相对更高（OR，2.021；95%CI，1.944-2.102）。与维吾尔族相比，汉族、哈萨克族、回族和蒙古族的 MCC 发病风险增加，分别为（OR，1.075；95%CI，1.040-1.111）、（OR，1.414；95%CI，1.332-1.501）、（OR，1.515；95%CI，1.396-1.644）、（OR，1.566；95%CI，1.216-2.017）。
新疆社区老年人的多种慢性疾病存在民族和地域差异。居住在新疆北部和南部以及汉族、哈萨克族、蒙古族和回族的老年人发生多种慢性疾病的风险较高。
