Multimorbidity, functional limitation, difficulty taking medications independently, and unmet community healthcare service needs among older adults in China: a cross-sectional analysis of the 2023 CLASS wave

Multimorbidity is increasingly common among older adults. However, limited evidence is available on its association with difficulty taking medications independently, including whether this association varies by functional limitation and how the coexistence of disease burden and medication-taking difficulty relates to unmet community healthcare service needs. This study examined the association between multimorbidity and difficulty taking medications independently among older adults in China, and further explored combined-status profiles from a health services perspective. This cross-sectional study used data from the 2023 China Longitudinal Aging Social Survey (CLASS). The descriptive sample included 11,670 adults aged 60 years or older. Multimorbidity was defined as two or more physician-diagnosed chronic conditions. Difficulty taking medications independently was derived from a single functional item asking whether respondents could take medications by themselves. Multivariable logistic regression was used to examine the association between multimorbidity and difficulty taking medications independently. Secondary analyses examined effect modification by functional limitation and the association between combined-status profiles and unmet community healthcare service needs among participants reporting service need. Among the 11,655 participants with available chronic-condition data, 5,311 (45.6%) had multimorbidity. Overall, 573 participants (4.9%) reported difficulty taking medications independently. In the primary model, multimorbidity was associated with higher odds of difficulty taking medications independently (adjusted OR = 2.682, 95% CI: 2.163–3.324). Functional limitation showed a strong association with the outcome (adjusted OR = 16.495, 95% CI: 13.140–20.708). The multiplicative interaction between multimorbidity and functional limitation was statistically significant (interaction OR = 0.219, 95% CI: 0.120–0.398). Despite an interaction OR below 1, the adjusted probability of difficulty taking medications independently was highest among participants with both multimorbidity and functional limitation. Among participants reporting at least one community healthcare service need, the combined-vulnerability profile was associated with higher odds of unmet need (adjusted OR = 2.197, 95% CI: 1.604–3.008). Among older adults in China, multimorbidity was associated with difficulty taking medications independently, and this association varied by functional limitation. Older adults with both multimorbidity and difficulty taking medications independently also had higher odds of unmet community healthcare service needs among those reporting service need. These findings support integrating disease burden, functional status, and medication-taking ability into the assessment of service-related vulnerability and needs-based community health service planning.