July 9, 2025Aging Clinical and Experimental ResearchOpen Access

Individual-level transitions between chronic disease multimorbidity clusters and the risk of five-year mortality in longitudinal cohort of Chinese middle-aged and older adults

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Chronic disease multimorbidity (n=8988). Intervention: Transition from multisystem multimorbidity to respiratory diseases vs. Healthy participants (no chronic diseases). Primary outcome: Five-year all-cause mortality (HR 9.04, 95% CI 3.44-23.73, p=<0.001).

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Key result

Participants who had multisystem multimorbidity and further developed respiratory diseases had a 5-year all-cause mortality risk 9 times higher than healthy participants (HR 9.04).

Population

8988 Chinese middle-aged and older adults

Comparison

Multimorbidity cluster transition trajectories and chronic disease accumulation vs healthy participants

Design

Longitudinal cohort study

Authors

YMYiming Ma HZHuizi Zhang PWPeigang Wang

Discussion

Member takes

Overview

Supports monitoring multimorbidity transitions for mortality risk stratification; leaves open causal effects and intervention targets in older adults.

Study Design

Type

Cohort (n=8,988)

Multicenter

Yes

Structured PICO

Population

8,988 middle-aged and older adults in China, including 7,144 with at least one chronic condition and 1,844 healthy counterparts, followed for 5 years to assess mortality risk associated with multimorbidity transitions.

Comparator

Participants with no chronic diseases (no-NCD counterparts)

Outcome

Five-year all-cause mortality (2015-2020)hard clinical

Main Result

Hazard Ratio: 9.04 (95% CI 3.44–23.73)

p-value: p=<0.001

Longitudinal transitions into multisystem and respiratory multimorbidity clusters, as well as the accumulation of chronic diseases, significantly compound the 5-year mortality risk in middle-aged and older adults.

Limitations

CHARLS questionnaire did not cover all chronic diseases prevalent in older adults.
Latent class analysis does not directly model longitudinal disease-disease interactions.
Data were collected at follow-up intervals rather than timely clinical diagnoses.
Wide confidence intervals for certain transition trajectories due to small subgroup sizes.
Lifestyle factors were dichotomized, which may obscure dose-dependent relationships.
Prioritized transitions between multimorbidity clusters among individuals with baseline chronic diseases, rather than tracking initial transitions from a healthy state.
Small subgroup size for some transitions (e.g., n=17) reducing statistical power
Exclusion of undiagnosed or subclinical conditions
Attrition bias with excluded individuals being younger/less severely ill or older/less educated

Cite This Study

Ma et al. (2025) conducted a cohort in Chronic disease multimorbidity (n=8,988). Transition from multisystem multimorbidity to respiratory diseases vs. Healthy participants (no chronic diseases) was evaluated on Five-year all-cause mortality (HR 9.04, 95% CI 3.44-23.73, p=<0.001). Participants who had multisystem multimorbidity and further developed respiratory diseases had a 5-year all-cause mortality risk 9 times higher than healthy participants (HR 9.04).

synapsesocial.com/papers/6a7ca631e7df423ee14c767c https://doi.org/10.1007/s40520-025-03078-5

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July 9, 2025Aging Clinical and Experimental ResearchOpen Access

Individual-level transitions between chronic disease multimorbidity clusters and the risk of five-year mortality in longitudinal cohort of Chinese middle-aged and older adults

View Full Paper

Ask AI

Bookmark

Key result

Participants who had multisystem multimorbidity and further developed respiratory diseases had a 5-year all-cause mortality risk 9 times higher than healthy participants (HR 9.04).

Population

8988 Chinese middle-aged and older adults

Comparison

Multimorbidity cluster transition trajectories and chronic disease accumulation vs healthy participants

Design

Longitudinal cohort study

Authors

YMYiming Ma HZHuizi Zhang PWPeigang Wang

Discussion

Member takes

Overview

Supports monitoring multimorbidity transitions for mortality risk stratification; leaves open causal effects and intervention targets in older adults.

Study Design

Type

Cohort (n=8,988)

Multicenter

Yes

Structured PICO

Population

Comparator

Participants with no chronic diseases (no-NCD counterparts)

Outcome

Five-year all-cause mortality (2015-2020)hard clinical

Main Result

Hazard Ratio: 9.04 (95% CI 3.44–23.73)

p-value: p=<0.001

Limitations

CHARLS questionnaire did not cover all chronic diseases prevalent in older adults.
Latent class analysis does not directly model longitudinal disease-disease interactions.
Data were collected at follow-up intervals rather than timely clinical diagnoses.
Wide confidence intervals for certain transition trajectories due to small subgroup sizes.
Lifestyle factors were dichotomized, which may obscure dose-dependent relationships.
Prioritized transitions between multimorbidity clusters among individuals with baseline chronic diseases, rather than tracking initial transitions from a healthy state.
Small subgroup size for some transitions (e.g., n=17) reducing statistical power
Exclusion of undiagnosed or subclinical conditions
Attrition bias with excluded individuals being younger/less severely ill or older/less educated

Cite This Study

synapsesocial.com/papers/6a7ca631e7df423ee14c767c https://doi.org/10.1007/s40520-025-03078-5

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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