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Background <p>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.</p> Methods <p>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.</p> Results <p>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.</p> Conclusion <p>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.</p>

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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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月9日

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  • Xiashan Dong,
  • Yiming Ma,
  • Huizi Zhang,
  • Peigang Wang

摘要

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.