Multimorbidity Patterns and Cognitive Transitions Among the Elderly in China: The Longitudinal Evidence From CLHLS

This study explored how different multimorbidity patterns impact transitions between cognitive stages in the elderly in China using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The data included 8778 dementia-free participants aged ≥60 years (21 500 observations). At baseline, K-Means clustering identified 3 multimorbidity patterns: cardiovascular, sensory, and multisystem. A multistate Markov model estimated transition probabilities. Results showed that compared with the sensory pattern, the cardiovascular pattern (hazard ratio [HR] 0.45, 95% CI [0.34, 0.60]) and the multisystem pattern (HR 0.48, 95% CI [0.37, 0.63]) were associated with a lower risk of progression from normal cognition to cognitive impairment. The sojourn time for normal cognition in the sensory pattern is shorter than that in cardiovascular and multisystem patterns. At age 80, the sojourn time for cognitive impairment in the sensory pattern is longer (1.96 years) than that in others (1.42 and 1.55 years) but converged with other patterns at ages 90 and 100. Different multimorbidity patterns exhibit distinct transitions between cognitive stages. Targeted interventions based on risk factors may mitigate cognitive decline in the elderly.