Patterns of multimorbidity in association with falls among the middle-aged and older adults: results from the China Health and Retirement Longitudinal Study

Abstract

Background: Chronic diseases are important risk factors of falls. However, most studies explored the effect of a single chronic disease on falls and few studies explored the combined effect of multiple chronic diseases on falls. In this study, we examined the associations between falls and multimorbidity and multimorbidity patterns.

Methods: Data collected between 2011 and 2018 were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multimorbidity was defined as the coexistence of ≥ 2 chronic diseases in the same person. The multimorbidity patterns were identified with exploratory factor analysis (EFA). The longitudinal associations of multimorbidity and multimorbidity patterns with falls were examined with generalized estimating equations methodology.

Results: Compared with patients without chronic conditions, patients with one, two, and ≥ 3 chronic diseases had 37%, 85%, and 175% increased risk of falls, respectively. The EFA identified four multimorbidity patterns and the factor scores in the cardiac-metabolic pattern [adjusted odds ratio (aOR): 1.16, 95% confidence interval (95% CI): 1.12-1.20)], visceral-arthritic pattern (aOR: 1.31, 95% CI: 1.28-1.35), respiratory pattern (aOR: 1.12, 95% CI: 1.10-1.16), and mental-sensory pattern (aOR: 1.31, 95% CI: 1.28-1.35) were all associated with a higher risk of falls.

Conclusion: Multimorbidity and multimorbidity patterns are related to falls. Older adults with multiple chronic diseases require early interventions to prevent falls.

Keywords: CHARLS; China; Chronic diseases; Falls; Multimorbidity patterns.