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Outline
To explore the association between multimorbidity trajectories and intrinsic capacity (IC) impairment among community-dwelling older adults.
Based on hospital information system (HIS) data from Jiading District, Shanghai, from 2018 to 2023 and a community survey conducted in 2024, 2 406 participants aged ≥60 years who completed the five-domain IC assessment and had ≥3 medical records cumulatively were included. Multimorbidity was defined as having ≥2 chronic diseases simultaneously. IC was assessed across five domains according to WHO recommendations, and impairment in any domain was defined as IC impairment. A group-based trajectory model (GBTM) was used to identify multimorbidity trajectories, and logistic regression was employed to analyze the association with IC impairment.
GBTM identified three trajectories: low-level stable (31.5%), medium-level slow-growth(52.8%), and high-level stable (15.6%). The prevalence of IC impairment was 55.0% in 2024. After full adjustment, multimorbidity was associated with IC impairment (OR=1.23, 95% CI: 1.03-1.48), and the risk significantly increased when the number of chronic diseases was ≥4. Compared with the low-level stable group, the risks of IC impairment were elevated in the medium-level slow-growth group (OR=1.28, 95% CI: 1.06-1.55) and the high-level stable group (OR=1.65, 95% CI: 1.26-2.18). Age significantly modified the association (P=0.036), with a more pronounced association in the group aged 70-79 years.
Multimorbidity burden is substantial among community-dwelling older adults, with heterogeneous trajectories. Higher trajectory levels are associated with greater risk of IC impairment. High-risk populations should be identified through trajectory analysis, and IC assessment should be incorporated into community follow-up to support early intervention.
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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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