Comorbidity patterns and implications for disease control: a network analysis of medical records from Shanghai, China

The aging problem in Shanghai is rapidly increasing, leading to the development of chronic comorbidities in older adults. Studying the correlations within comorbidity patterns can assist in managing disease prevention and implicate early control.

This study was a cross-sectional analysis based on a large sample size of 3,779,756 medical records. A network analysis and community classification were performed to illustrate disease networks and the internal relationships within comorbidity patterns among older adults in Shanghai.

The network analysis and community classification were performed using the IsingFit and Fast-greedy community functions. Datasets, including disease codes and disease prevalence, were collected from medical records.

The top five prevalent diseases were hypertension (64.78%), chronic ischemic heart disease (39.06%), type 2 diabetes mellitus (24.97%), lipid metabolism disorders (21.79%), and gastritis (19.71%). The sampled population showed susceptibility to 11 comorbidities associated with hypertension, 9 with diabetes, 28 with ischemic heart disease, 26 with gastritis, and 2 with lipid metabolism disorders in male patients. Diseases such as lipid metabolism disorders, gastritis, fatty liver, polyps of the colon, osteoporosis, atherosclerosis, and heart failure exhibited strong centrality.

The most common comorbidity patterns were dominated by ischemic heart disease and gastritis, followed by a ternary pattern between hypertension, diabetes, and lipid metabolism disorders. Male patients were more likely to have comorbidities related to cardiovascular and sleep problems, while women were more likely to have comorbidities related to thyroid disease, inflammatory conditions, and hyperuricemia. It was suggested that healthcare professionals focus on monitoring relevant vital signs and mental health according to the specific comorbidity patterns in older adults with chronic diseases, to prevent the development of new or more severe comorbidities.