Socioeconomic disparities in the prevalence of non-communicable chronic disease multimorbidity and their impact on activities of daily living among older adults in rural southwest China: a cross-sectional study

This study investigates socioeconomic disparities in the prevalence of five non-communicable chronic diseases (NCDs) — hypertension, diabetes, coronary heart disease (CHD), stroke, and chronic obstructive pulmonary disease (COPD) — and their multimorbidity, and examines the relationship between NCDs multimorbidity and activities of daily living (ADL) among older adults in rural southwest China. A cross-sectional health interview and survey of 5,548 consenting adults aged ≥ 60 years was conducted. An individual socioeconomic position (SEP) index was constructed using principal component analysis. Anthropometric measurements, blood pressure, fasting blood glucose, and post-bronchodilator spirometry tests were recorded for each participant. ADL was evaluated using the Lawton scale. The overall prevalence of hypertension, diabetes, CHD, stroke, COPD, and their multimorbidity was 65.8%, 13.7%, 8.5%, 5.9%, 7.3%, and 22.8%, respectively. Participants with a lower education level had a higher prevalence of hypertension than their counterparts (P < 0.01), while participants with better access to medical services had a higher prevalence of diabetes than their counterparts (P < 0.05). Individuals with higher annual household income and SEP had a higher prevalence of diabetes, COPD, and NCDs multimorbidity than their counterparts (P < 0.01). Multivariable binary logistic regression analysis revealed that individuals with NCDs multimorbidity had a greater probability of impairments in ADL, physical activities of daily living (PADL), and instrumental activities of daily living (IADL) (OR = 1.27, OR = 1.28, and OR = 1.79, respectively, all P < 0.01). Socioeconomic disparities are significantly associated with the prevalence of NCDs and their multimorbidity among older adults in rural southwest China. Multimorbidity is linked to a higher likelihood of functional limitations in ADL. This research uncovers the need to improve ADL among older adults with NCDs multimorbidity.