Accelerated multimorbidity in early adulthood and long-term functional disability in later life: a life-course...

Chronic somatic diseases (CSDs), particularly cardiometabolic diseases (CMDs) are recognized contributors to functional disability, yet limited evidence examines these associations by employing longitudinal approaches.

This study aimed to investigate the association between early adulthood patterns of CMDs and other CSDs with the incidence and trajectories of later-life functional disability.

Data were drawn from the China Health and Retirement Longitudinal Study implemented during 2011-2020. Functional disability was measured by activities of daily living (ADL) and instrumental activities of daily living (IADL). Latent class trajectory modeling was used to identify 10-year trajectories of functional disability. Sequence analysis was used to cluster CSD patterns from ages 18 to 44 and time-dependent Cox proportional hazard models and logistical regressions were employed to detect the associations between early adulthood CSD patterns and the incident risk and longitudinal trajectory of functional disability in later life.

Among 7,077 participants, four distinct early adulthood disease patterns were identified: (I) "Long-term health," (II) "Long-term with a non-CMD CSD", (III) "Later fast transition to CMDs or non-CMD CSDs", and (IV) "Early transition to CMDs or multimorbidity". After adjusting for covariates, participants with a history of CSDs showed higher risks of functional disability.

This study confirms that early adulthood patterns of CSDs are differentially associated with later-life functional disability, through the establishment of a lifespan-based disease-disability research framework and multi-disease trajectory modeling. Early diagnosis and interventions for CSDs are important to sustain functional function in aging.

Not applicable.