Sequential Patterns and Transition Timelines of Chronic Disease Comorbidities in Obesity: Evidence from the ELSA...

To characterize the sequential patterns and transition timelines of chronic disease comorbidities in population with obesity.

We analyzed population with obese from the English Longitudinal Study of Ageing, including 22,355 independent participants for using association rule mining (ARM) to identify comorbidity patterns and 92,092 person-observations to analyze disease progression pathways and transition probability by multi-stage Markov chain (MMC). Health burden was compared between different onset disease.

ARM identified cardiovascular (CVD), metabolic (MTD), and skeletal-muscular disease (SMD) as the most prevalent disease trio. MMC revealed 40% of obese individual will develop a chronic disease within 5 years, and nearly 30% with MTD or CVD will develop to the trio within 10 years. Progression times to the trio differed significantly based on initial disease type (p < 0.003), with MTD onset being the fastest progression (3.89 years). SMD onset was associated with the most adverse health burden profile, including the highest depression rate (6.3%), poorest sleep quality (77.0%), and substantial work limitations (74.0%).

These findings establish quantifiable transition probabilities and timelines for chronic disease progression, emphasizing the important role of onset disease and contributing empirical evidence for the sequential nature of multimorbidity development.