Individual-level transitions between chronic disease multimorbidity clusters and the risk of five-year mortality in longitudinal cohort of Chinese middle-aged and older adults.

Abstract

Background: We aimed to trace individual's transition between multimorbidity clusters and examine the addictive and compounding effects of transition trajectories, chronic disease accumulation, and five-year all-cause mortality.

Methods: Participants from the China Health and Retirement Longitudinal Study (2011-2020) were included (N = 8988). Latent class analyses, Cox proportional hazard models, and restricted cubic splines were used to examine the associations.

Results: Five clusters were identified: osteoarticular, cardiometabolic, multisystem, digestive, and respiratory. Participants who had multisystem multimorbidity and further developed respiratory diseases had mortality risk 9 times higher than the healthy participants (HR:9.04; 95% CI 3.44-23.73). For participants experienced prolonged cardiometabolic multimorbidity, the mortality risk increased by 26% with each additional chronic disease and by 38% with each additional body system affected between 2011 and 2015.

Conclusion: Subsequent interventions should prioritize those who experienced prolonged multi-system multimorbidity, developed respiratory diseases from existing multi-system conditions, or developed additional chronic diseases from existing cardiometabolic multimorbidity.