The impact of multimorbidity on health‑related quality of life among older adults in China: a longitudinal study

Purpose The objective of this study was to assess the impact of multimorbidity on health-related quality of life (HRQoL) and the five HRQoL dimensions—mobility, self-care, usual activities, pain/discomfort, and anxiety/depression—among older adults in China. Methods Longitudinal data from two waves (2018 and 2020) of the China Health and Retirement Longitudinal Study were used, including 5,330 participants (aged ≥ 60). The EuroQol 5-Dimensions 3-Level scale was used to measure HRQoL, with higher scores indicating better overall life and health status. In contrast, higher scores in any of the five HRQoL dimensions indicated poorer health and life status. This study used mixed-effects linear regression to assess the impact of multimorbidity on HRQoL, including the five HRQoL dimensions. Results The prevalence of multimorbidity among 5,330 participants was 70.39%. Multimorbidity was associated with a reduction in HRQoL (B =-0.024; 95% CI : -0.027, -0.021). Furthermore, multimorbidity was linked to poorer health outcomes across four specific dimensions: self-care (B = 0.003; 95% CI : 0.002, 0.004), usual activities (B = 0.003; 95% CI : 0.0028, 0.0037), pain/discomfort (B = 0.0077; 95% CI : 0.007, 0.008), and anxiety/depression (B = 0.01; 95% CI : 0.008, 0.012). However, there was no statistically significant association between multimorbidity and mobility (B = 0.001; 95% CI : -0.001, 0.002). Conclusion This study indicated that multimorbidity negatively affected both HRQoL and its four dimensions (self-care ability, usual activities, pain /discomfort, and depression /anxiety) among older adults. Several strategies to enhance improve HRQoL in older adults included the prevention of multimorbidity and the targeted interventions and nursing care for individuals with multimorbidity.