Study On The Prevalence And Pattern Of Multimorbidity Among The Elderly

Objective:Through cross-sectional investigation and research,taking Taiyuan City as an example,this study understands the current status of multimorbidity in the elderly and their influencing factors,and explores the correlation between chronic diseases to study the common chronic disease combination patterns in the elderly.Provide data and theoretical support for the formulation of management and prevention and control strategies and measures for multimorbidity;provide reference for improving the health of the elderly and optimizing the prevention and management of chronic diseases.Methods:By using the method of multi-stage cluster random sampling,3637 elderly people over 60 years old were selected from Taiyuan city of Shanxi Province to conduct face-to-face questionnaire survey.Qualitative data were described by frequency,chi square test was used to compare the prevalence of multiple chronic diseases in the elderly with different demographic data groups,and disordered multi classification logistic regression model was used to analyze the influencing factors of multiple chronic diseases in the elderly.The data flow was established by modeler software,the potential association between chronic diseases was observed by Web graph,and the association between chronic diseases was explored by Apriori association rule algorithm,factor analysis and cluster analysis.Results:(1)The prevalence of chronic diseases among the elderly in Taiyuan is 68.85%,and the prevalence of multiple chronic diseases is 20.95%.There were only 522 people suffering from 2 chronic diseases,accounting for 68.50%;167 people suffering from 3chronic diseases,accounting for 21.92%.The number of multimorbidity in the elderly was mainly two and three.(2)The results of the disordered multi-class logistic regression model showed that advanced age(60-69 years old as the reference group,70-79 years old,OR=1.728,P<0.001;≥80 years old,OR=2.181,P<0.001),Irregular diet(OR=1.840,P=<0.001)and family history(OR=11.329,P<0.001)are at higher risk of multiple chronic diseases.Normal weight or thin(take BMI≥24 as the reference group,BMI18.5～,OR=0.724,P=0.002;BMI<18.5,OR=0.539,P=0.002)high physical activity intensity(OR=0.649,P=0.002)is a protective factor for the elderly suffering from multiple chronic diseases.(3)In the selected association rules,sorted according to the degree of support,the three most common binary chronic disease combination modes are diabetes + hypertension,coronary heart disease + diabetes,and coronary heart disease + hypertension.The support is 13.23%,6.13%,6.13%;the three most common ternary chronic disease combinations are coronary heart disease + hypertension + diabetes,rheumatoid arthritis + osteoporosis +hypertension,rheumatoid arthritis + hypertension + diabetes,The support levels were2.81%,2.26%,and 2.26% respectively.(4)Seven multiple chronic disease prevalence patterns were identified through factor analysis: hearing impairment + eye disease,factor rheumatoid arthritis + osteoporosis,coronary heart disease + arrhythmia + obesity,hypertension + atherosclerosis Like sclerosis,gastritis + bronchial asthma,diabetes + stroke,cancer + gout.(5)Through the use of cluster analysis,eight types of multiple chronic disease combination patterns were identified: Type 1: rheumatoid arthritis and osteoporosis,Type 2:bronchial asthma,gastritis,Type 3: hearing impairment,eye disease,and type 4.:Hypertension,atherosclerosis,five categories: diabetes,stroke,six categories: coronary heart disease,arrhythmia,seven categories: obesity,gout,eight categories: cancer.Conclusions:The multiple prevalence rate of the elderly aged 60 and above is 20.95%,and the prevalence rate of chronic diseases is 68.85%.The current status of chronic diseases is not optimistic.The high incidence of multimorbidity is mainly concentrated on the elderly,obesity,low physical activity intensity,irregular diet,family history and other specific populations,which require special attention.In the results of association rules,the highest number of association rules related to hypertension was obtained,followed by diabetes.The top two prevalence rates are also hypertension and diabetes.It can be seen that these two chronic diseases are not only high in the population.Prevalence,and there are extensive associations between these two diseases and between each and other diseases.The three most common multiple chronic disease combinations are diabetes + hypertension,coronary heart disease + diabetes,and coronary heart disease + hypertension.the results of cluster analysis and factor analysis have high similarities.Bronchial asthma and gastritis,hypertension and atherosclerosis,diabetes and stroke,coronary heart disease and arrhythmia are all a multiple chronic disease pattern in the results of factor analysis and cluster analysis.The combination of Apriori association rule analysis method,factor analysis method and cluster analysis method is conducive to exploring the correlation between chronic diseases from multiple angles,and better exploring and analyzing multiple chronic disease prevalence patterns,providing for the management,prevention and control of chronic diseases.Relevant departments can predict the possibility of other chronic diseases based on the common multiple chronic disease combination patterns,combined with the current chronic diseases,and do the screening,diagnosis and prevention of related diseases in advance.