Association of multimorbidity and its patterns with risk of mortality among the elderly in Shenzhen, China

This study aimed to identify multimorbidity pattern in the elderly population, and to investigate the associations of multimorbidity and its patterns with risk of mortality. A total of 107,217 participants aged ≥ 65, with 47,205 men and 60,012 women, were enrolled from Shenzhen, China in 2018 and followed up to 2023. Hierarchical cluster analysis was used to identified multimorbidity pattern among 10 chronic diseases. Cox proportional hazard model was used to measure mortality risk of multimorbidity and its patterns. Multimorbidity was present in 74,545 participants (69.53%). Three multimorbidity patterns were identified: cardiometabolic pattern (including 47,020 participants, comprising cardiovascular disease, cerebrovascular disease, hypertension, dyslipidemia, and diabetes); sensory and hepatic disorder pattern (including 11,766 participants, comprising liver disease, hearing impairment, and visual impairment); and hematological-renal pattern (including 1,961 participants, comprising kidney disease and anemia). Compared with participants without multimorbidity, the hazard ratios (HRs) for mortality were 1.29 (95% CI: 1.22–1.37, P < 0.001) for multimorbidity, 1.36 (95% CI: 1.28–1.44, P < 0.001) for cardiometabolic pattern, 1.20 (95% CI: 1.10–1.30, P < 0.001) for sensory and hepatic disorder pattern and 1.94 (95% CI: 1.66–2.31, P < 0.001) for hematological-renal pattern. In this prospective study of 107,217 participants aged ≥ 65 years, we demonstrated that multimorbidity was associated with an increased mortality risk. Three distinct multimorbidity patterns were identified, each of which conveyed a heightened mortality risk warranting further attention. These findings offer a scientific reference for future research and clinical management of multimorbidity in older adults.