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Multimorbidity patterns and health-related quality of life among community-dwelling older adults: evidence from a rural town in Suzhou, China

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Abstract

Purpose

The high prevalence of multimorbidity in aging societies has posed tremendous challenges to the healthcare system. The aim of our study was to comprehensively assess the association of multimorbidity patterns and health-related quality of life (HRQOL) among rural Chinese older adults.

Methods

This was a cross-sectional study. Data from 4,579 community-dwelling older adults aged 60 years and above was collected by the clinical examination and questionnaire survey. Information on 10 chronic conditions was collected and the 3-Level EQ-5D (EQ-5D-3L) was adopted to measure the HRQOL of older adults. An exploratory factor analysis was performed to determine multimorbidity patterns. Regression models were fitted to explore the associations of multimorbidity patterns with specific health dimensions and overall HRQOL.

Results

A total of 2,503 (54.7%) participants suffered from multimorbidity, and they reported lower HRQOL compared to those without multimorbidity. Three kinds of multimorbidity patterns were identified including cardiovascular-metabolic diseases, psycho-cognitive diseases and organic diseases. The associations between psycho-cognitive diseases/organic diseases and overall HRQOL assessed by EQ-5D-3L index score were found to be significant (β = − 0.097, 95% CI − 0.110, − 0.084; β = − 0.030, 95% CI − 0.038, − 0.021, respectively), and psycho-cognitive diseases affected more health dimensions. The impact of cardiovascular-metabolic diseases on HRQOL was largely non-significant.

Conclusion

Multimorbidity was negatively associated with HRQOL among older adults from rural China. The presence of the psycho-cognitive diseases pattern or the organic diseases pattern contributed to worse HRQOL. The remarkable negative impact of psycho-cognitive diseases on HRQOL necessiates more attention and relevant medical assistance to older rural adults.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Makovski, T. T., Schmitz, S., Zeegers, M. P., Stranges, S., & van den Akker, M. (2019). Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing research reviews, 53, 100903. https://doi.org/10.1016/j.arr.2019.04.005

    Article  PubMed  Google Scholar 

  2. Van Wilder, L., Devleesschauwer, B., Clays, E., De Buyser, S., Van der Heyden, J., Charafeddine, R., Boeckxstaens, P., De Bacquer, D., Vandepitte, S., & De Smedt, D. (2022). The impact of multimorbidity patterns on health-related quality of life in the general population: Results of the Belgian Health Interview Survey. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation, 31(2), 551–565. https://doi.org/10.1007/s11136-021-02951-w

    Article  PubMed  Google Scholar 

  3. The, L. (2018). Making more of multimorbidity: An emerging priority. Lancet (London, England), 391(10131), 1637. https://doi.org/10.1016/s0140-6736(18)30941-3

    Article  Google Scholar 

  4. Skou, S. T., Mair, F. S., Fortin, M., Guthrie, B., Nunes, B. P., Miranda, J. J., Boyd, C. M., Pati, S., Mtenga, S., & Smith, S. M. (2022). Multimorbidity. Nature reviews. Disease primers, 8(1), 48. https://doi.org/10.1038/s41572-022-00376-4

    Article  PubMed  Google Scholar 

  5. Fan, J., Sun, Z., Yu, C., Guo, Y., Pei, P., Yang, L., Chen, Y., Du, H., Sun, D., Pang, Y., Zhang, J., Gilbert, S., Avery, D., Chen, J., Chen, Z., Lyu, J., & Li, L. (2022). Multimorbidity patterns and association with mortality in 0.5 million Chinese adults. Chinese Medical Journal, 135(6), 648–657. https://doi.org/10.1097/cm9.0000000000001985

    Article  PubMed  PubMed Central  Google Scholar 

  6. McPhail, S. M. (2016). Multimorbidity in chronic disease: Impact on health care resources and costs. Risk management and healthcare policy, 9, 143–156. https://doi.org/10.2147/rmhp.S97248

    Article  PubMed  PubMed Central  Google Scholar 

  7. Marengoni, A., Angleman, S., & Fratiglioni, L. (2011). Prevalence of disability according to multimorbidity and disease clustering: a population-based study. Journal of comorbidity, 1, 11–18. https://doi.org/10.15256/joc.2011.1.3

    Article  PubMed  PubMed Central  Google Scholar 

  8. Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., Meinow, B., & Fratiglioni, L. (2011). Aging with multimorbidity: A systematic review of the literature. Ageing research reviews, 10(4), 430–439. https://doi.org/10.1016/j.arr.2011.03.003

    Article  PubMed  Google Scholar 

  9. Haywood, K. L., Garratt, A. M., & Fitzpatrick, R. (2005). Quality of life in older people: A structured review of generic self-assessed health instruments. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation, 14(7), 1651–1668. https://doi.org/10.1007/s11136-005-1743-0

    Article  CAS  PubMed  Google Scholar 

  10. Kanesarajah, J., Waller, M., Whitty, J. A., & Mishra, G. D. (2018). Multimorbidity and quality of life at mid-life: A systematic review of general population studies. Maturitas, 109, 53–62. https://doi.org/10.1016/j.maturitas.2017.12.004

    Article  PubMed  Google Scholar 

  11. Wong, E. L. Y., Xu, R. H., & Cheung, A. W. L. (2019). Measuring the impact of chronic conditions and associated multimorbidity on health-related quality of life in the general population in Hong Kong SAR, China: A cross-sectional study. PLoS ONE, 14(11), e0224970. https://doi.org/10.1371/journal.pone.0224970

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Liu, X., Zhang, J., Zhang, S., Peng, S., Pei, M., Dai, C., Wang, T., & Zhang, P. (2023). Quality of life and associated factors among community-dwelling adults with multimorbidity in Shanghai, China: A cross-sectional study. Nursing open, 10(8), 5328–5337. https://doi.org/10.1002/nop2.1770

    Article  PubMed  PubMed Central  Google Scholar 

  13. She, R., Yan, Z., Jiang, H., Vetrano, D. L., Lau, J. T. F., & Qiu, C. (2019). Multimorbidity and Health-Related Quality of Life in Old Age: Role of Functional Dependence and Depressive Symptoms. Journal of the American Medical Directors Association, 20(9), 1143–1149. https://doi.org/10.1016/j.jamda.2019.02.024

    Article  PubMed  Google Scholar 

  14. Gu, J., Chao, J., Chen, W., Xu, H., Zhang, R., He, T., & Deng, L. (2018). Multimorbidity and health-related quality of life among the community-dwelling elderly: A longitudinal study. Archives of gerontology and geriatrics, 74, 133–140. https://doi.org/10.1016/j.archger.2017.10.019

    Article  PubMed  Google Scholar 

  15. Prados-Torres, A., Calderón-Larrañaga, A., Hancco-Saavedra, J., Poblador-Plou, B., & van den Akker, M. (2014). Multimorbidity patterns: A systematic review. Journal of clinical epidemiology, 67(3), 254–266. https://doi.org/10.1016/j.jclinepi.2013.09.021

    Article  PubMed  Google Scholar 

  16. Luo, D., Deng, J., & Becker, E. R. (2021). Urban-rural differences in healthcare utilization among beneficiaries in China’s new cooperative medical scheme. BMC Public Health, 21(1), 1519. https://doi.org/10.1186/s12889-021-11573-3

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lin, H., Jin, M., Liu, Q., Du, Y., Fu, J., Sun, C., Ma, F., Li, W., Liu, H., Zhang, X., Zhu, Y., Chen, Y., Sun, Z., Wang, G., Huang, G., & Yan, J. (2021). Gender-specific prevalence and influencing factors of depression in elderly in rural China: A cross-sectional study. Journal of affective disorders, 288, 99–106. https://doi.org/10.1016/j.jad.2021.03.078

    Article  PubMed  Google Scholar 

  18. Alexopoulos, G. S. (2005). Depression in the elderly. Lancet (London, England), 365(9475), 1961–1970. https://doi.org/10.1016/s0140-6736(05)66665-2

    Article  PubMed  Google Scholar 

  19. Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A. S. (2015). Depression and Quality of Life in Older Persons: A Review. Dementia and geriatric cognitive disorders, 40(5–6), 311–339. https://doi.org/10.1159/000437299

    Article  PubMed  Google Scholar 

  20. Lu, H., Dong, X. X., Li, D. L., Wu, Q., Nie, X. Y., Xu, Y., Wang, P., & Pan, C. W. (2023). Prevalent falls, fall frequencies and health-related quality of life among community-dwelling older Chinese adults. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation. https://doi.org/10.1007/s11136-023-03474-2

    Article  PubMed  Google Scholar 

  21. Liu, J. H., Zhang, Y. J., Ma, Q. H., Sun, H. P., Xu, Y., & Pan, C. W. (2020). Elevated blood neutrophil to lymphocyte ratio in older adults with cognitive impairment. Archives of gerontology and geriatrics, 88, 104041. https://doi.org/10.1016/j.archger.2020.104041

    Article  PubMed  Google Scholar 

  22. Yang, X. J., Tian, S., Ma, Q. H., Sun, H. P., Xu, Y., & Pan, C. W. (2020). Leukocyte-related parameters in older adults with metabolic syndrome. Endocrine, 68(2), 312–319. https://doi.org/10.1007/s12020-020-02243-2

    Article  CAS  PubMed  Google Scholar 

  23. Yang, W. Y., Li, J., Zhao, C. H., Qian, D. J., Niu, Z., Shen, W., Yuan, Y., Zhong, H., & Pan, C. W. (2016). Population-based assessment of visual impairment among ethnic Dai adults in a rural community in China. Scientific reports, 6, 22590. https://doi.org/10.1038/srep22590

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Hodkinson, H. M. (1972). Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and ageing, 1(4), 233–238. https://doi.org/10.1093/ageing/1.4.233

    Article  CAS  PubMed  Google Scholar 

  25. Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of general internal medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Chen, S., Chiu, H., Xu, B., Ma, Y., Jin, T., Wu, M., & Conwell, Y. (2010). Reliability and validity of the PHQ-9 for screening late-life depression in Chinese primary care. International journal of geriatric psychiatry, 25(11), 1127–1133. https://doi.org/10.1002/gps.2442

    Article  PubMed  Google Scholar 

  27. Wang, H. M., Patrick, D. L., Edwards, T. C., Skalicky, A. M., Zeng, H. Y., & Gu, W. W. (2012). Validation of the EQ-5D in a general population sample in urban China. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation, 21(1), 155–160. https://doi.org/10.1007/s11136-011-9915-6

    Article  PubMed  Google Scholar 

  28. Zhao, F. L., Yue, M., Yang, H., Wang, T., Wu, J. H., & Li, S. C. (2010). Validation and comparison of EuroQol and short form 6D in chronic prostatitis patients. Value in health : The journal of the International Society for Pharmacoeconomics and Outcomes Research, 13(5), 649–656. https://doi.org/10.1111/j.1524-4733.2010.00728.x

    Article  PubMed  Google Scholar 

  29. Brooks, R. (1996). EuroQol: The current state of play. Health policy (Amsterdam, Netherlands), 37(1), 53–72. https://doi.org/10.1016/0168-8510(96)00822-6

    Article  CAS  PubMed  Google Scholar 

  30. Liu, G. G., Guan, H., Jin, X., Zhang, H., Vortherms, S. A., & Wu, H. (2022). Rural population’s preferences matter: A value set for the EQ-5D-3L health states for China’s rural population. Health and quality of life outcomes, 20(1), 14. https://doi.org/10.1186/s12955-022-01917-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Suzhou Statistics Bureau. (2014). Suzhou Statistical Yearbook 2014. China Statistics Press.

    Google Scholar 

  32. Busija, L., Lim, K., Szoeke, C., Sanders, K. M., & McCabe, M. P. (2019). Do replicable profiles of multimorbidity exist? Systematic review and synthesis. European journal of epidemiology, 34(11), 1025–1053. https://doi.org/10.1007/s10654-019-00568-5

    Article  PubMed  Google Scholar 

  33. Prados-Torres, A., Poblador-Plou, B., Calderón-Larrañaga, A., Gimeno-Feliu, L. A., González-Rubio, F., Poncel-Falcó, A., Sicras-Mainar, A., & Alcalá-Nalvaiz, J. T. (2012). Multimorbidity patterns in primary care: Interactions among chronic diseases using factor analysis. PLoS ONE, 7(2), e32190. https://doi.org/10.1371/journal.pone.0032190

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. MacRae, C., Mercer, S. W., Henderson, D., McMinn, M., Morales, D. R., Jefferson, E., Lyons, R. A., Lyons, J., Dibben, C., McAllister, D. A., & Guthrie, B. (2023). Age, sex, and socioeconomic differences in multimorbidity measured in four ways: UK primary care cross-sectional analysis. The British journal of general practice : The journal of the Royal College of General Practitioners, 73(729), e249–e256. https://doi.org/10.3399/bjgp.2022.0405

    Article  PubMed  Google Scholar 

  35. Han, K. T., Park, E. C., Kim, J. H., Kim, S. J., & Park, S. (2014). Is marital status associated with quality of life? Health and quality of life outcomes, 12, 109. https://doi.org/10.1186/s12955-014-0109-0

    Article  PubMed  PubMed Central  Google Scholar 

  36. Pathirana, T. I., & Jackson, C. A. (2018). Socioeconomic status and multimorbidity: A systematic review and meta-analysis. Australian and New Zealand Journal Of Public Health, 42(2), 186–194. https://doi.org/10.1111/1753-6405.12762

    Article  PubMed  Google Scholar 

  37. Majoni, M., & Oremus, M. (2017). Does being a retired or employed caregiver affect the association between behaviours in Alzheimer’s disease and caregivers’ health-related quality-of-life? BMC Research Notes, 10(1), 766. https://doi.org/10.1186/s13104-017-3099-2

    Article  PubMed  PubMed Central  Google Scholar 

  38. Luo, N., Wang, Y., How, C. H., Tay, E. G., Thumboo, J., & Herdman, M. (2015). Interpretation and use of the 5-level EQ-5D response labels varied with survey language among Asians in Singapore. Journal of clinical epidemiology, 68(10), 1195–1204. https://doi.org/10.1016/j.jclinepi.2015.04.011

    Article  PubMed  Google Scholar 

  39. Cheung, J. T. K., Yu, R., Wu, Z., Wong, S. Y. S., & Woo, J. (2018). Geriatric syndromes, multimorbidity, and disability overlap and increase healthcare use among older Chinese. BMC geriatrics, 18(1), 147. https://doi.org/10.1186/s12877-018-0840-1

    Article  PubMed  PubMed Central  Google Scholar 

  40. Hu, X., Huang, J., Lv, Y., Li, G., & Peng, X. (2015). Status of prevalence study on multimorbidity of chronic disease in China: Systematic review. Geriatrics & gerontology international, 15(1), 1–10. https://doi.org/10.1111/ggi.12340

    Article  Google Scholar 

  41. Wang, H. H., Wang, J. J., Wong, S. Y., Wong, M. C., Li, F. J., Wang, P. X., Zhou, Z. H., Zhu, C. Y., Griffiths, S. M., & Mercer, S. W. (2014). Epidemiology of multimorbidity in China and implications for the healthcare system: Cross-sectional survey among 162,464 community household residents in southern China. BMC medicine, 12, 188. https://doi.org/10.1186/s12916-014-0188-0

    Article  PubMed  PubMed Central  Google Scholar 

  42. Gu, J., Chao, J., Chen, W., Xu, H., Wu, Z., Chen, H., He, T., Deng, L., & Zhang, R. (2017). Multimorbidity in the community-dwelling elderly in urban China. Archives of gerontology and geriatrics, 68, 62–67. https://doi.org/10.1016/j.archger.2016.09.001

    Article  PubMed  Google Scholar 

  43. Divo, M. J., Martinez, C. H., & Mannino, D. M. (2014). Ageing and the epidemiology of multimorbidity. The European respiratory journal, 44(4), 1055–1068. https://doi.org/10.1183/09031936.00059814

    Article  PubMed  PubMed Central  Google Scholar 

  44. Sheridan, P. E., Mair, C. A., & Quiñones, A. R. (2019). Associations between prevalent multimorbidity combinations and prospective disability and self-rated health among older adults in Europe. BMC geriatrics, 19(1), 198. https://doi.org/10.1186/s12877-019-1214-z

    Article  PubMed  PubMed Central  Google Scholar 

  45. Tang, L. H., Thygesen, L. C., Willadsen, T. G., Jepsen, R., la Cour, K., Frølich, A., Møller, A., Jørgensen, L. B., & Skou, S. T. (2020). The association between clusters of chronic conditions and psychological well-being in younger and older people-A cross-sectional, population-based study from the Lolland-Falster Health Study, Denmark. Journal of comorbidity, 10, 2235042x20981185 https://doi.org/10.1177/2235042x20981185

  46. Schultz, S. E., & Kopec, J. A. (2003). Impact of chronic conditions. Health reports, 14(4), 41–53.

    PubMed  Google Scholar 

  47. Tazzeo, C., Rizzuto, D., Calderón-Larrañaga, A., Roso-Llorach, A., Marengoni, A., Welmer, A. K., Onder, G., Trevisan, C., & Vetrano, D. L. (2021). Multimorbidity patterns and risk of frailty in older community-dwelling adults: A population-based cohort study. Age and ageing, 50(6), 2183–2191. https://doi.org/10.1093/ageing/afab138

    Article  PubMed  PubMed Central  Google Scholar 

  48. Vinkers, D. J., Gussekloo, J., Stek, M. L., Westendorp, R. G., & van der Mast, R. C. (2004). Temporal relation between depression and cognitive impairment in old age: Prospective population based study. BMJ (Clinical research ed.), 329(7471), 881. https://doi.org/10.1136/bmj.38216.604664.DE

    Article  PubMed  Google Scholar 

  49. Jorm, A. F. (2001). History of depression as a risk factor for dementia: An updated review. The Australian and New Zealand journal of psychiatry, 35(6), 776–781. https://doi.org/10.1046/j.1440-1614.2001.00967.x

    Article  CAS  PubMed  Google Scholar 

  50. Sampath, D., Sathyanesan, M., & Newton, S. S. (2017). Cognitive dysfunction in major depression and Alzheimer’s disease is associated with hippocampal-prefrontal cortex dysconnectivity. Neuropsychiatric disease and treatment, 13, 1509–1519. https://doi.org/10.2147/ndt.S136122

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Bao, X. Y., Xie, Y. X., Zhang, X. X., Peng, X., Huang, J. X., Du, Q. F., & Wang, P. X. (2019). The association between multimorbidity and health-related quality of life: A cross-sectional survey among community middle-aged and elderly residents in southern China. Health and quality of life outcomes, 17(1), 107. https://doi.org/10.1186/s12955-019-1175-0

    Article  PubMed  PubMed Central  Google Scholar 

  52. Yan, C., Liao, H., Ma, Y., Xiang, Q., & Wang, J. (2021). Association among multimorbidity, physical disability and depression trajectories: A study of urban-rural differences in China. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation, 30(8), 2149–2160. https://doi.org/10.1007/s11136-021-02807-3

    Article  PubMed  Google Scholar 

  53. Seidel, G., Röttinger, A., Lorenzen, J., Kücken, D., Majewski, A., Klose, K., Terborg, C., Klass, I., Wohlmuth, P., Zukunft, E., & Debacher, U. (2019). Quality of life and disability after severe stroke and early neurological rehabilitation. Der Nervenarzt, 90(10), 1031–1036. https://doi.org/10.1007/s00115-019-0740-4

    Article  PubMed  Google Scholar 

  54. Moons, P., & Luyckx, K. (2019). Quality-of-life research in adult patients with congenital heart disease: current status and the way forward. Acta paediatrica (Oslo, Norway : 1992), 108(10), 1765–1772. https://doi.org/10.1111/apa.14876

  55. Olanrewaju, O., Trott, M., Smith, L., López Sánchez, G. F., Carmichael, C., Oh, H., Schuch, F., Jacob, L., Veronese, N., Soysal, P., Shin, J. I., Butler, L., Barnett, Y., & Koyanagi, A. (2023). Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation, 32(4), 1031–1041. https://doi.org/10.1007/s11136-022-03317-6

    Article  PubMed  Google Scholar 

  56. National Academies of Sciences, E., Medicine, Health, Medicine, D., Board on Population, H., Public Health, P., Committee on Public Health Approaches to Reduce Vision, I., & Promote Eye, H. (2016). The National Academies Collection: Reports funded by National Institutes of Health. In A. Welp, R. B. Woodbury, M. A. McCoy & S. M. Teutsch (Eds.), Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington (DC): National Academies Press (US) Copyright 2016 by the National Academy of Sciences. All rights reserved.

  57. Leadley, R. M., Armstrong, N., Reid, K. J., Allen, A., Misso, K. V., & Kleijnen, J. (2014). Healthy aging in relation to chronic pain and quality of life in Europe. Pain practice : The official journal of World Institute of Pain, 14(6), 547–558. https://doi.org/10.1111/papr.12125

    Article  PubMed  Google Scholar 

  58. Aoki, T., Fukuhara, S., Fujinuma, Y., & Yamamoto, Y. (2021). Effect of multimorbidity patterns on the decline in health-related quality of life: A nationwide prospective cohort study in Japan. British Medical Journal Open, 11(6), e047812. https://doi.org/10.1136/bmjopen-2020-047812

    Article  Google Scholar 

  59. Tran, V. T., Harrington, M., Montori, V. M., Barnes, C., Wicks, P., & Ravaud, P. (2014). Adaptation and validation of the Treatment Burden Questionnaire (TBQ) in English using an internet platform. BMC medicine, 12, 109. https://doi.org/10.1186/1741-7015-12-109

    Article  PubMed  PubMed Central  Google Scholar 

  60. Abdin, E., Subramaniam, M., Vaingankar, J. A., Luo, N., & Chong, S. A. (2015). Population norms for the EQ-5D index scores using Singapore preference weights. Quality of life research : An international journal of quality of life aspects of treatment, care and rehabilitation, 24(6), 1545–1553. https://doi.org/10.1007/s11136-014-0859-5

    Article  PubMed  Google Scholar 

  61. Li, X., Wu, C., Lu, J., Chen, B., Li, Y., Yang, Y., Hu, S., & Li, J. (2020). Cardiovascular risk factors in China: A nationwide population-based cohort study. The Lancet. Public health, 5(12), e672–e681. https://doi.org/10.1016/s2468-2667(20)30191-2

    Article  PubMed  Google Scholar 

  62. Yan, R., Li, W., Yin, L., Wang, Y., & Bo, J. (2017). Cardiovascular Diseases and Risk-Factor Burden in Urban and Rural Communities in High-, Middle-, and Low-Income Regions of China: A Large Community-Based Epidemiological Study. Journal of the American Heart Association, 6(2). https://doi.org/10.1161/jaha.116.004445

  63. Yao, S. S., Cao, G. Y., Han, L., Chen, Z. S., Huang, Z. T., Gong, P., Hu, Y., & Xu, B. (2020). Prevalence and Patterns of Multimorbidity in a Nationally Representative Sample of Older Chinese: Results From the China Health and Retirement Longitudinal Study. The journals of gerontology. Series A, Biological sciences and medical sciences, 75(10), 1974–1980. https://doi.org/10.1093/gerona/glz185

  64. Zhang, X., Dupre, M. E., Qiu, L., Zhou, W., Zhao, Y., & Gu, D. (2017). Urban-rural differences in the association between access to healthcare and health outcomes among older adults in China. BMC geriatrics, 17(1), 151. https://doi.org/10.1186/s12877-017-0538-9

    Article  PubMed  PubMed Central  Google Scholar 

  65. Cheng, C., Yang, C. Y., Inder, K., & Wai-Chi Chan, S. (2020). Urban-rural differences in mental health among Chinese patients with multiple chronic conditions. International journal of mental health nursing, 29(2), 224–234. https://doi.org/10.1111/inm.12666

    Article  PubMed  Google Scholar 

  66. Xiang, Y., Zare, H., Guan, C., & Gaskin, D. (2018). The impact of rural-urban community settings on cognitive decline: Results from a nationally-representative sample of seniors in China. BMC geriatrics, 18(1), 323. https://doi.org/10.1186/s12877-018-1003-0

    Article  PubMed  PubMed Central  Google Scholar 

  67. Diederichs, C., Berger, K., & Bartels, D. B. (2011). The measurement of multiple chronic diseases--a systematic review on existing multimorbidity indices. The journals of gerontology. Series A, Biological sciences and medical sciences, 66(3), 301–311. https://doi.org/10.1093/gerona/glq208

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Acknowledgements

We frankly thank all participants involved in the survey, as well as other staff members on the scene.

Funding

The study has been sponsored by the National Natural Science Foundation of China (Project No. 72274037) awarded to Dr. Pei Wang.

Author information

Author notes

  1. Heng Lu and Xing-Xuan Dong contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China

    Heng Lu, Xing-Xuan Dong, Dan-Lin Li, Xin-Yi Nie & Chen-Wei Pan

  2. School of Public Health, Fudan University, Shanghai, China

    Pei Wang

  3. Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China (Fudan University), Shanghai, China

    Pei Wang

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  1. Heng Lu
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HL: Visualization, Formal analysis, Writing—original draft, Writing—review & editing. X-XD: Visualization, Formal analysis, Writing—original draft, Writing—review & editing. D-L L: Writing—review & editing. X-YN: Writing—review & editing. PW: Conceptualization, Visualization, Formal analysis, Writing—original draft, Writing—review & editing, Validation, Funding. C-WP: Conceptualization, Visualization, Formal analysis, Writing—original draft, Writing—review & editing, Validation, Funding.

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Correspondence to Pei Wang or Chen-Wei Pan.

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The authors declare that there are no conflicts of interest in relation to the subject of this study.

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The Weitang Geriatric Disease study adhered to the tenets of the Helsinki Declaration and ethics approval was obtained from the Institutional Review Board of the Soochow University.

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All participants gave written informed consent at the recruitment stage of the study.

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Lu, H., Dong, XX., Li, DL. et al. Multimorbidity patterns and health-related quality of life among community-dwelling older adults: evidence from a rural town in Suzhou, China. Qual Life Res 33, 1335–1346 (2024). https://doi.org/10.1007/s11136-024-03608-0

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