title: Prevalence and Patterns of Chronic Disease Pairs and Multimorbidity among Older Chinese Adults Living in a Rural Area.
abstract: BACKGROUND
  The burden of chronic diseases in China is substantial now. Data on patterns of chronic diseases and multimorbidity among older adults, especially among those living in rural areas, are sparse.
  
  
  OBJECTIVE
  We aim to investigate the prevalence and patterns of chronic disease pairs and multimorbidity in elderly people living in rural China.
  
  
  METHODS
  This population-based study included 1480 adults aged 60 years and over (mean age 68.5 years, 59.4% women) living in a rural community. Data were derived from the Confucius Hometown Aging Project in Shandong, China (June 2010-July 2011). Chronic diseases were diagnosed through face-to-face interviews, clinical examinations, and laboratory tests. Patterns of chronic disease pairs and multimorbidity were explored using logistic regression and exploratory factor analyses.
  
  
  RESULTS
  The prevalence of individual chronic diseases ranged from 3.0% for tumor to 76.4% for hypertension, and each disease was often accompanied with three or more other chronic diseases. The observed prevalence of pairs of chronic conditions exceeded the expected prevalence for several conditions, such as cardiovascular diseases and metabolic disorders, as well as pulmonary diseases and degenerative disorders. Chronic multimorbidity (≥2 chronic diseases) affected more than 90% of subjects, and two patterns of chronic multimorbidity were identified: cardiopulmonary-mental-degenerative disorder pattern (overall prevalence, 58.2%), and cerebrovascular-metabolic disorder pattern (62.6%). Prevalence of the cardiopulmonary-mental-degenerative disorder pattern increased with age, and was higher in men than women; whereas prevalence of the cerebrovascular-metabolic disorder pattern was higher in women than in men but did not vary by age.
  
  
  CONCLUSIONS
  Chronic multimorbidity was highly prevalent among older Chinese adults living in rural areas, and there were specific patterns of the co-occurrence of chronic diseases. Effort is needed to identify possible preventative strategies based on the potential clustering of chronic diseases.
authors.affiliation: Aging Research Center, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Neurology, Jining No. 1 People's Hospital, Shandong, China.
authors.forename: Zhongrui
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Aging Research Center, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; School of Public Health, Jining Medical University, Shandong, China.
authors.forename: Yajun
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Aging Research Center, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Edwin C K
authors.initials: EC
authors.lastname: Tan
authors.affiliation: Xing Long Zhuang Hospital, Yankuang Group, Shandong, China.
authors.forename: Chuanzhu
authors.initials: C
authors.lastname: Cai
authors.affiliation: Xing Long Zhuang Hospital, Yankuang Group, Shandong, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: School of Public Health, Jining Medical University, Shandong, China.
authors.forename: Aiqin
authors.initials: A
authors.lastname: Song
authors.affiliation: Aging Research Center, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
authors.forename: Chengxuan
authors.initials: C
authors.lastname: Qiu
mesh_terms: D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012424:Rural Population