Multimorbidity Networks in Older Adults：Structural Characteristics and Socioecological Determinants

Objective Research of multimorbidity network for older adults (≥ 65years) based on nationwide is concerningly scare. The aim of this study was to investigate the characteristics of the network structure of multiple chronic diseases among the elderly population in China and its socioecological determinants. Methods We analyzed cross-sectional data from wave 7 of the 23 provinces Survey of Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. Results The older multimorbidity network displayed distinct structural features. Hypertension has the highest incidence rate and is the most central disease in the network. Tuberculosis, epilepsy, and bedsores had the highest network effective sizes and efficiency. However, tuberculosis, bedsores, and dyslipidemia had the lowest constraint and hierarchy. The multimorbidity network for old adults could be divided into eight subgroups, with varying degrees associations of inter-group and intra-group diseases. The regression coefficients for male gender and mildew odor in the home were positive, while the coefficient for sleep duration > 7 hours was negative. The significance tests showed that all coefficients had p-values less than 0.05. Conclusions The multimorbidity network for older adults exhibits typical network structure characteristics, which are influenced by factors such as gender, family environment, and sleep time. These findings highlight the need for collaborative efforts from families, health care system, and policymakers to improve quality of life in the older adultswith multimorbidity.