Regional living conditions as risk factors for comorbid conditions development in the Russian Federation regions’ elderly populations

Rationale. The aim of the study is to analyze the associations of regional characteristics with the individual risk of comorbidity in the elderly population in the subjects of the Russian Federation. Materials and methods. The material of the cross-sectional study «Epidemiology of cardiovascular diseases in the regions of the Russian Federation» (ESSE-RF-3), conducted in 2020—2022, was used as individual data. The analysis included 10535 men and women aged 60—74 years. The presence of comorbid conditions was assessed using 4 methodological approaches: 1 — according to the Order of the Ministry of Health of the Russian Federation dated 07/01/2021 No. 698n.; 2 — according to the Eurasian guidelines; 3 — according to the Charlson index; 4 — in accordance with the recommendations on the organization of prioritization of patients in the framework of follow-up. To describe the regional living conditions, an integral index assessment was used, which was previously performed using the principal component method. The association of comorbidity with regional indices was assessed using logistic regression analysis, with the calculation of odds ratios (OR) and a 95% confidence interval. Results. The deterioration of economic living conditions and the shift in the age structure of the region’s population towards older age is associated with comorbidity, regardless of the method of its assessment. An increase in the industrial development of the region is associated with a decrease in the probability of comorbidity, calculated according to the «Charlson index» OR=0.93 (0.90—0.97) and according to the «Methodological Recommendations» OR=0.94 (0.90—0.97). Conclusion. The conducted study demonstrated the influence of economic, industrial and demographic regional living conditions on the individual probability of comorbidity.