The association between multimorbidity and health-related quality of life: a cross-sectional survey among community middle-aged and elderly residents in southern China

BackgroundMultimorbidity is common among the middle-aged and elderly residents. And it is associated to the reduction of health-related quality of life (HRQoL), including physical and psychological dimensions. However, there are few studies that have paid attention to the HRQoL of residents with multimorbidity in China. Therefore, this study aims to investigate the relationships between different multimorbidity patterns and HRQoL among middle-aged and elderly adults in China.MethodsBased on a cross-sectional survey, the information regarding 18,137 adults, who were at least 45years of age, was collected through interviews. Self-perceived HRQoL was assessed with the EQ-5D-3L instrument, and the EQ-5D-3L index score was calculated using the Chinese EQ-5D-3L value set. The Tobit regression was used to explore the impacts of multimorbidity groups on HRQoL.ResultsOf 18,137 respondents, more than a fifth (3773,20.8%) of people had multimorbidity. Mean (SD) of EQ-5D index and VAS values were 0.95(0.14) and 76.02(13.66), respectively. Significant correlations were found between a lower HRQoL and increasing numbers of chronic conditions (P<0.001). Most of chronic diseases co-occurred frequently, and the association between hypertension and diabetes mellitus was the strongest (adjusted OR=3.82). The most prevalent disease is hypertension (5052,27.9%), and the most prevalent chronic diseases pair is hypertension and diabetes mellitus (841,4.6%). Among those chronic diseases with high prevalence, the effects on HRQoL ranged from chronic pain to hypertension (adjust b=-0.036 to -0.008). In the common multimorbidity patterns, co-occurrence of chronic pain and bone disease (adjust b=-0.039) had the greatest impact on HRQoL.ConclusionsThe HRQoL of middle-aged and elderly adults declines by multimorbidity. More attention should be paid to the HRQoL of residents with multimorbidity in China. The effect of different multimorbidity patterns on HRQoL is not simply added by two diseases, but changes by the different combination. Identifying different multimorbidity patterns of residents can provide more targeted measures to improve the HRQoL.