Prevalence of Multimorbidity and Its Associations with Health Literacy and Quality of Life Among Older Adults in an Urban Slum

Abstract Introduction: Multimorbidity, defined as the presence of two or more chronic conditions, is increasingly common among older adults and is associated with poor health outcomes, reduced quality of life, and increased healthcare utilization. Older adults living in urban slums are particularly vulnerable due to poverty, inadequate healthcare access, and poor living conditions. This study assessed the prevalence of multimorbidity and its association with health literacy and health-related quality of life. Methodology: A community-based cross-sectional study was conducted among 400 adults aged 60 years and above residing in an urban slum in Mysuru, Karnataka, from January to March 2025. Data were collected using a semi-structured questionnaire, the 47-item Health Literacy Scale, the 12-item Short Form Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. Associations were assessed using the Chi-square test, with p < 0.05 considered statistically significant. Results The prevalence of multimorbidity was 68.5% (274/400). It was significantly associated with increasing age (p < 0.001), female sex (56.6%; p < 0.001), widowhood (32.8%; p < 0.001), illiteracy (44.2%; p < 0.001), lower socioeconomic status (23.4% in Class V; p < 0.001), limited healthcare access (21.2%; p = 0.023), physical inactivity (26.3%; p < 0.001), and poorer health-related quality of life (79.2%; p = 0.011). Although 69.1% of participants with multimorbidity had inadequate health literacy, the association was not statistically significant (p = 0.266). Conclusion Multimorbidity is highly prevalent among older adults living in urban slums and is associated with adverse sociodemographic, behavioral, and quality-of-life outcomes. Targeted geriatric care and health literacy interventions are needed.