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Cited by 41Chronic Disease Management StrategiesPharmaceutical Practices and Patient OutcomesHealth, Nursing, Elderly Care

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Patterns and Determinants of Multimorbidity in Older Adults: Study in Health-Ecological Perspective

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Chen, Yiming, Shi, Lei, Zheng, Xiao, Yang, Juan, Xue, Yaqing, Xiao, Shujuan, Xue, Benli, Zhang, Jiachi, Li, Xinru, Lin, Huang, Ma, Chao, Zhang, Chichen·2022·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph192416756PMC PMC9779369
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Abstract

(1) Background: Multimorbidity has become one of the key issues in the public health sector. This study aims to explore the patterns and health-ecological factors of multimorbidity in China to propose policy recommendations for the management of chronic diseases in the elderly. (2) Methods: A multi-stage random sampling method was used to conduct a questionnaire survey on 3637 older adults aged 60 and older in Shanxi, China. Association rule mining analysis (ARM) and network analysis were applied to analyze the patterns of multimorbidity. The health-ecological model was adopted to explore the potential associated factors of multimorbidity in a multidimensional perspective. A hierarchical multiple logistic model was employed to investigate the association strengths reflected by adjusted odds ratios and 95% confidence. (3) Results: Multimorbidity occurred in 20.95% of the respondents. The graph of network analysis showed that there were 6 combinations of chronic diseases with strong association strengths and 14 with moderate association strengths. The results of the ARM were similar to the network analysis; six dyadic chronic disease combinations and six triadic ones were obtained. Hierarchical multiple logistic regression indicated that innate personal traits (age, history of genetics, and body mass index), behavioral lifestyle (physical activity levels and medication adherence), interpersonal network (marital status), and socioeconomic status (educational level) were the common predictors of multimorbidity for older adults, among which, having no family history was found to be a relative determinant as a protective factor for multimorbidity after controlling the other covariates. (4) Conclusions: multimorbidity was prevalent in older adults and most disease combinations are associated with hypertension, followed by diabetes. This shows that diabetes and hypertension have a high prevalence among older adults and have a wide range of associations with other chronic diseases. Exploring the patterns and associated factors of multimorbidity will help the country prevent complications and avoid the unnecessary use of the health service, adopting an integrated approach to managing multimorbidity rather than an individual disease-specific approach and implementing different strategies according to the location of residence.

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Metadata

Authors
Chen, Y., Shi, L., Zheng, X., Yang, J., Xue, Y., Xiao, S., Xue, B., Zhang, J., Li, X., Lin, H., Ma, C., & Zhang, C.
Affiliations
  • School of Health Management, Southern Medical University, Guangzhou 510515, China
  • Southern Medical University (CN)
  • Bengbu Medical College (CN)
  • Nanfang Hospital (CN)
Corresponding author
Zhang, Chichen
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2022-12-14
Volume
19
Issue
24
Pages
16756
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph192416756
PMC
PMC9779369
OpenAlex
W4311357892
Cited by
41
References
63
Citations by year
2026: 8 · 2025: 16 · 2024: 13 · 2023: 4
FWCI
5.96
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • National Natural Science Foundation of China (72274091, 71874104, 2022A1515011591, G620369695)
  • The Guangdong Basic and Applied Basic Research Foundation under Grant (72274091, 71874104, 2022A1515011591, G620369695)
  • The Philosophy and Social Sciences of Guangdong College for the project of Public Health Policy Research and Evaluation Key Laboratory under Grant (72274091, 71874104, 2022A1515011591, G620369695)
Topics
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Health Professions › General Health Professions › Health, Nursing, Elderly Care
Keywords
multimorbidity, older adults, hypertension, diabetes mellitus, family history (medicine), medication adherence, physical activity, socioeconomic status, marital status, integrated disease management, Shanxi Province
MeSH terms
Multimorbidity, Aged, China, Chronic Disease, Diabetes Mellitus, Humans, Hypertension, Middle Aged, Prevalence

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