Relationship between multimorbidity, disease cluster and all-cause mortality among older adults: a retrospective cohort analysis
Kun He, Wenli Zhang, Xueqi Hu, Hao Zhao, Bingxin Guo, Zhan Shi, Xiaoyan Zhao, Chunyu Yin, Songhe Shi
Abstract
Abstract Background Previous studies have evaluated the association of multimorbidity with higher mortality, but epidemiologic data on the association between the disease clusters and all-cause mortality risk are rare. We aimed to examine the relationship between multimorbidity (number/ cluster) and all-cause mortality in Chinese older adults. Methods We conducted a population-based study of 50,100 Chinese participants. Multiple logistic regression analysis was used to estimate the impact of long-term conditions (LTCs) on all-cause mortality. Results The prevalence of multimorbidity was 31.35% and all-cause mortality was 8.01% (50,100 participants). In adjusted models, the odds ratios (ORs) and 95% confidence intervals (CIs) of all-cause mortality risk for those with 1, 2, and ≥ 3 LTCs compared with those with no LTCs was 1.45 (1.32–1.59), 1.72 (1.55–1.90), and 2.15 (1.85–2.50), respectively ( P trend < 0.001). In the LTCs ≥2 category, the cluster of chronic diseases that included hypertension, diabetes, CHD, COPD, and stroke had the greatest impact on mortality. In the stratified model by age and sex, absolute all-cause mortality was higher among the ≥75 age group with an increasing number of LTCs. However, the relative effect size of the increasing number of LTCs on higher mortality risk was larger among those < 75 years. Conclusions The risk of all-cause mortality is increased with the number of multimorbidity among Chinese older adults, particularly disease clusters.