The Influencing Factors of Chronic Disease Comorbidities of Elderly in China Based on Health Ecology Model

• Published in: Zhongguo quanke yixue Vol. 26; no. 1; pp. 50 - 57
• Main Author: QI Yuantao, LIU Yan, DU Jin, LIU Yongwen, MA Guifeng
• Format: Journal Article
• Language: Chinese
• Published: Chinese General Practice Publishing House Co., Ltd 01.01.2023
• Subjects: multiple chronic conditions|aged|health ecology model|social determinants of health|healthy lifestyle|prevalence|root cause analysis
• ISSN: 1007-9572
• DOI: 10.12114/j.issn.1007-9572.2022.0458

Background The problem of population aging is serious in China, and chronic diseases comorbidity is becoming more and more common. Objective Based on the health ecology model, to systematically understand the main influencing factors of chronic disease comorbidity among the elderly in China, and to provide scientific reference for the prevention and control of chronic disease comorbidity among the elderly in China. Methods Based on the follow-up data of China Health and Retirement Longitudinal Study (CHARLS) 2018, a total of 10 779 samples aged ≥60 years were selected in March 2021. After excluding the samples with missing data and unqualified data, a total of 7 354 samples was included in this study. With the occurrence of chronic comorbidities (having ≥2 chronic conditions) as the dependent variable and the inclusion of independent variables according to the 5 dimensions of the health ecology model, a multivariate Logistic regression model was used to analyze the influencing factors of chronic disease comorbidity in the elderly. Results Among the elderly≥60 years old in China, the comorbidity rate of chronic diseases was 65.16% (4 792/7 354) , with 32.16% (1 541/4 792) patients suffered from two kinds of chronic diseases, and the diseases with the largest combination of two comorbidities were hypertension with arthritis or rheumatism〔16.42% (253/1 541) 〕. The results of the multivariate Logistic analysis showed that for the risk of comorbidities of chronic diseases in the elderly, females were higher than that in males〔OR (95%CI) =1.371 (1.177, 1.596) 〕, those over 70 years old were higher than those aged 60-70 years old〔OR (95%CI) =1.189 (1.061, 1.333) 〕, those who slept for 6-8 hours or more than 8 hours at night were lower than those who slept for less than 6 hours at night〔OR (95%CI) =0.759 (0.678, 0.850) , OR (95%CI) =0.686 (0.572, 0.821) 〕, those who took nap time of 0.5-1.0 h and over 1.0 h were higher than those of less than 0.5 h 〔OR (95%CI) =1.238 (1.102, 1.391) , OR (95%CI) =1.219 (1.604, 1.396) 〕, those who felt general and less satisfied with their health were higher than those who were very satisfied〔OR (95%CI) =1.755 (1.537, 2.004) , OR (95%CI) =5.890 (4.930, 7.037) 〕, those who registered in urban areas were higher than those in the rural areas〔OR (95%CI) =1.167 (1.036, 1.315) 〕, those living in the central and western regions were higher than those in the eastern region〔OR (95%CI) =1.311 (1.158, 1.483) , OR (95%CI) =1.491 (1.315, 1.692) 〕, those who were working were lower than those who had worked〔OR (95%CI) =0.768 (0.680, 0.866) 〕, and those with annual income > 50 000 per capita were higher than that of less than 20 000 yuan〔OR (95%CI) =1.413 (1.009, 1.978) 〕. Conclusion The incidence of chronic diseases comorbidity is higher in the elderly in China. The influencing factors of comorbidity of chronic diseases are multi-level and multi-dimensional. There are complex relationships between different influencing factors, which suggest strengthening multi-dimensional intervention and management of chronic diseases from individual to environment, so as to improve the health level of the population.