To investigate the prevalence of physical-psychological-cognitive multimorbidity patterns and their impact on the risk of falls among older adults in China.

Data were drawn from the CHARLS 2018-2020. A total of 6 431 participants aged 60 years and older were included. Physical-psychological-cognitive multimorbidity patterns were assessed in 2018 using self-reported physician-diagnosed diseases, the Center for Epidemiologic Studies Depression Scale, and the Mini-Mental State Examination. Falls were assessed in 2020 by self-reported fall events in the past two years. Poisson regression models with robust standard errors were used to analyse the association between multimorbidity patterns and the risk of falls.

1 228(19.1%) out of 6 431 participants aged 60 years and older had experienced a fall in the past two years. In terms of the physical-psychological-cognitive multimorbidity pattern, the highest proportion of older adults had only physical illnesses (33.9%), followed by physical illnesses plus cognitive impairment (17.8%) and physical-psychological-cognitive multimorbidity (16.9%). The lowest proportions were observed for older adults with psychological illnesses plus cognitive impairment (2.2%) and those with only psychological illnesses (1.6%). Compared with older adults without any illnesses, the risk of falling increased by 73%(aRRs: 1.73, 95%CI: 1.33-2.26), 83%(aRRs: 1.83, 95%CI: 1.11-3.03), 70%(aRRs: 1.70, 95%CI: 1.29-2.23), 164%(aRRs: 2.64, 95%CI: 2.02-3.43), and 182%(aRRs: 2.82, 95%CI: 2.17-3.67) for those with only physical illnesses, only psychological illnesses, physical illnesses plus cognitive impairment, physical plus psychological illnesses, and physical-psychological-cognitive multimorbidity, respectively.

Most combinations of physical, psychological, and cognitive disorders increase the risk of falls in older adults. Compared with older adults without any illness, the risk of falling was significantly elevated for those with comorbid physical and psychological illnesses, and the risk was highest for those with physical-psychological-cognitive multimorbidity. Interventions are needed to reduce the risk of falls in older adults with physical-psychological-cognitive multimorbidity.