Association between single and multiple cardiometabolic diseases and all-cause mortality among Chinese older adults:
Jin Yang1, Mei-Li Zhao2, Li-Hong Jiang3
1School of Nursing, Tianjin Medical University, Tianjin, 300070, China.
Insights
Multiple cardiometabolic diseases (CMDs) significantly increase mortality risk in older adults. The risk escalates with each additional CMD, particularly for males and younger seniors.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiometabolic diseases (CMDs) are a major cause of death and disability.
- The cumulative impact of multiple CMDs on mortality remains understudied, especially in older populations.
Purpose of the Study:
- To investigate the association between single and multiple CMDs and all-cause mortality.
- To analyze these associations in a large cohort of older Chinese adults.
Main Methods:
- Utilized data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2008-2018).
- Employed Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
- Included 11,351 participants aged 60+ with follow-up over a decade.
Main Results:
- A dose-response relationship was observed: each additional CMD increased mortality risk by 17%.
- Fully-adjusted HRs for all-cause mortality were 1.16, 1.36, and 2.03 for one, two, and three CMDs, respectively.
- Increased mortality risk from CMDs was more pronounced in males and younger seniors.
Conclusions:
- CMDs multiply mortality risks, with synergistic effects observed.
- The coexistence of heart disease and stroke poses the highest risk, further elevated by diabetes.
- Public health strategies should focus on CMD prevention and management.
Background And Aim:
Cardiometabolic diseases (CMDs) are leading causes of death and disability, but little is known about the additive mortality effects of multiple CMDs. This study aimed to examine the association between single and multiple CMDs and all-cause mortality among older Chinese population.
Methods And Results:
Using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database, we analyzed data from 2008 to 2018 to assess the relationship between CMDs and mortality. Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for single and multiple CMDs. At baseline, 11,351 participants (56.9% female) aged 60 years or older were included. 11.91% of participants had a single CMD, 1.51% had two CMDs, and 0.22% had three CMDs. Over a decade follow-up, 8992 deaths (79.2%) were recorded. A dose-response relationship was observed, with the mortality risk increasing by 17% for each additional disease. The fully-adjusted HRs for all-cause mortality were 1.16, 1.36, and 2.03 for one, two, and three CMDs, respectively. Larger effects of single and multiple CMDs were observed in the male group (P = 0.015) and the younger senior group (P < 0.001).
Conclusions:
This large-scale study found that CMDs multiply mortality risks, especially in younger seniors and males. The risk is highest when heart disease and stroke coexist, and diabetes further increases it. Public health efforts should prioritize evidence-based management and prevention of CMDs.
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