Chronic disease and multimorbidity in the Chinese older adults’ population and their impact on daily living ability: A cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

Background: Owing to an increase in life expectancy, it is common for the older adults to suffer from chronic diseases that can result in disability and a low quality of life. This study aimed to explore the influence of chronic diseases and comorbidities on activities of daily living (ADLs) and instrumental ADLs (IADLs) in an older Chinese populations. Methods: Based on the Chinese Longitudinal Healthy Longevity Survey (2018), 11,068 older adults aged 65 years and above were included in the study. A self-administered questionnaire was used to collect information on demographic characteristics, chronic diseases, ADLs, and IADLs. The impact of factors affecting ADL and IADL impairment in older adults was analysed using binary logistic regression. Results: In total, 64.8% participants had chronic diseases. Hypertension, heart disease, arthritis, and cerebrovascular disease were among the top chronic diseases. Of these, 32.1% participants had multimorbidities. The most common combination of the two chronic diseases was hypertension and heart disease (10.5%), whereas the most common combination of the three chronic diseases was hypertension, heart disease, and diabetes (2.87%). After categorising the older adults into four age groups, dementia, Parkinson's disease, respiratory disease, visual impairment, and hearing impairment were found to be more prevalent with increasing age. The prevalence of hypertension, heart disease, cerebrovascular disease, gastrointestinal ulcers, and arthritis gradually increased with age until the age of 75 years, peaked in the 75–84 years age group, and then showed a decreasing trend with age. The prevalence of chronic diseases and multimorbidities followed similar trends. Regression analysis indicated that physical activity, educational background, number of chronic diseases, and age were the most significant factors influencing ADLs and IADLs. In contrast, obesity and underweight status were linked to increased risks of impaired ADLs and IADLs, as referenced by normal body mass index. Conclusion: Chronic diseases and multimorbidities are common in older adults, and it is important to note that aging, multimorbidity, obesity, underweight, and unhealthy lifestyle choices may interfere with ADLs in older adults. Therefore, it is imperative that primary healthcare providers pay special attention to older adults and improve screening for comorbidities and follow-up needs.