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To explore the comorbidity patterns in middle-aged and older adults and their relationship with subjective life expectancy, as well as to investigate the mediating role of depression.
Using data from the 2020 CHARLS, latent class analysis (LCA) was employed to identify comorbidity patterns in individuals aged 45 and older. Ordered logistic regression was used to analyze the association between comorbidity patterns and subjective life expectancy, while stepwise regression and the KHB method were utilized to assess the mediating effect of depression.
A total of 13 815 middle-aged and older participants were included, with a comorbidity rate of 48.17%. LCA identified four comorbidity patterns: relatively healthy, gastrointestinal-arthritis, cardiovascular-metabolic, and respiratory system. The gastrointestinal-arthritis (OR=0.652, 95%CI: 0.592 to 0.717), cardiovascular-metabolic (OR=0.727, 95%CI: 0.669 to 0.791), and respiratory system (OR=0.518, 95%CI: 0.592-0.717) patterns were negatively associated with subjective life expectancy. Depression acted as a mediator, with heterogeneity in the mediating effect across different comorbidity patterns; the strongest effect was observed in the gastrointestinal-arthritis group, with an indirect effect value of -0.110 (-0.144 to -0.076), accounting for 27.72% of the mediating effect, followed by the cardiovascular-metabolic group (18.05%).
Compared to the relatively healthy group, the other three comorbidity patterns were associated with more negative subjective life expectancy, with depression mediating the relationship between comorbidity patterns and subjective life expectancy.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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