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Multimorbidity Patterns and Cognitive Transitions Among the Elderly in China: The Longitudinal Evidence From CLHLS
Jinglin Huang1, Jixiang Yang1, Yiren Song1
1Department of Medical Informatics, Zhejiang University School of Medicine, Hangzhou, China.
Asia-Pacific Journal of Public Health
|June 19, 2026
Summary
Different multimorbidity patterns significantly affect cognitive decline in China's elderly. Cardiovascular and multisystem patterns show a lower risk of cognitive impairment compared to sensory patterns.
Area of Science:
- Gerontology
- Epidemiology
- Cognitive Science
Background:
- Multimorbidity is common in the elderly and impacts health outcomes.
- Understanding how specific multimorbidity patterns influence cognitive decline is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between distinct multimorbidity patterns and cognitive stage transitions in Chinese older adults.
- To identify which multimorbidity patterns are linked to a higher or lower risk of cognitive impairment progression.
Main Methods:
- Utilized data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with 8778 dementia-free participants (≥60 years).
- Employed K-Means clustering to identify multimorbidity patterns (cardiovascular, sensory, multisystem).
- Applied a multistate Markov model to estimate cognitive transition probabilities and sojourn times.
Main Results:
- Cardiovascular (HR 0.45) and multisystem (HR 0.48) multimorbidity patterns were associated with a reduced risk of progressing from normal cognition to cognitive impairment compared to the sensory pattern.
- The sensory pattern showed a shorter sojourn time in normal cognition and a longer sojourn time in cognitive impairment at age 80.
- Cognitive stage transition dynamics varied significantly across the identified multimorbidity patterns.
Conclusions:
- Multimorbidity patterns differentially influence cognitive trajectory in older adults.
- The findings suggest that interventions targeting risk factors associated with specific multimorbidity patterns may help mitigate cognitive decline.
- Personalized strategies based on an individual's multimorbidity profile are essential for promoting healthy cognitive aging.
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