Liu Qian, Lin Shuzhi, Yin Lin, Liu Wei, Zhu Xiaoying, Li Zimeng, Shen Yifang, Feng Bianling
The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
Front Public Health. 2025 Jul 21;13:1597224. doi: 10.3389/fpubh.2025.1597224. eCollection 2025.
Multimorbidity presents a significant global health challenge, particularly among older people in China; however, research on its patterns and dynamic evolution remains limited. This study examines chronic disease co-occurrence and associated risk factors, identifying multimorbidity trends to inform health management and policy.
This study utilized the latest five-wave national survey data from the China Health and Retirement Longitudinal Study (CHARLS) on 2,798 individuals aged 60 years or older with multimorbidity. Latent class analysis (LCA) identified distinct multimorbidity patterns from 14 self-reported chronic conditions. Longitudinal follow-up data were then used to construct transition frequency matrices, modeling the trajectory and dynamic evolution of multimorbidity among older people in China over time.
Using LCA, 2,798 participants were classified into four patterns: the multi-system disorder group (10.33%), the gastrointestinal metabolism group (44.07%), the cardiovascular disease group (37.81%), and the respiratory disease group (7.79%). Over five waves, the gastrointestinal metabolism group declined (from 74.70% in 2011 to 44.07% in 2020), while the cardiovascular group increased (from 15.87 to 37.81%). The multi-system and respiratory groups also grew. Transition analysis showed the gastrointestinal metabolism group was the least stable, with many shifting to the cardiovascular group (7.29% from 2013 to 2015, 23.81% from 2015 to 2018, 18.54% from 2018 to 2020).
The disease burden among older people is shifting from gastrointestinal metabolism disorders to cardiovascular diseases, with gastrointestinal issues potentially acting as precursors to cardiovascular conditions. Future research should investigate the risk factors influencing transitions between multimorbidity patterns and their underlying mechanisms.
多病共存是一项重大的全球健康挑战，在中国老年人中尤为突出；然而，关于其模式和动态演变的研究仍然有限。本研究考察慢性病共病情况及相关风险因素，确定多病共存趋势，为健康管理和政策提供依据。
本研究利用了中国健康与养老追踪调查（CHARLS）最新的五轮全国调查数据，涉及2798名患有多种疾病的60岁及以上老年人。潜在类别分析（LCA）从14种自我报告的慢性病中识别出不同的多病共存模式。然后，利用纵向随访数据构建转移频率矩阵，模拟中国老年人多病共存随时间的轨迹和动态演变。
通过潜在类别分析，2798名参与者被分为四种模式：多系统疾病组（10.33%）、胃肠代谢组（44.07%）、心血管疾病组（37.81%）和呼吸系统疾病组（7.79%）。在五轮调查中，胃肠代谢组有所下降（从2011年的74.70%降至2020年的44.07%），而心血管疾病组有所增加（从15.87%增至37.81%）。多系统疾病组和呼吸系统疾病组也有所增长。转移分析显示，胃肠代谢组最不稳定，许多人转向心血管疾病组（2013年至2015年为7.29%，2015年至2018年为23.81%，2018年至2020年为18.54%）。
老年人的疾病负担正从胃肠代谢紊乱转向心血管疾病，胃肠问题可能是心血管疾病的先兆。未来的研究应调查影响多病共存模式之间转变的风险因素及其潜在机制。
