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Multimorbidity patterns of chronic diseases among community-dwelling older adults in Yuexiu District, Guangzhou, 2020: a network analysis
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Wenwen WEN1, Aishanjiang Reyimai1, Jun HUANG2, Zhiyi CHEN1, Yuanxin CHEN1, Xi CAO1, Zhisheng LAI3, Yufeng CHEN3, Yumei XUE2, Chen YANG1
Chinese Journal of Public Health | 2026, 42(3) : 295 - 300
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Chinese Journal of Public Health | 2026, 42(3): 295-300
• Special Report—Chronic Disease Prevention and Control •
Multimorbidity patterns of chronic diseases among community-dwelling older adults in Yuexiu District, Guangzhou, 2020: a network analysis
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Wenwen WEN1, Aishanjiang Reyimai1, Jun HUANG2, Zhiyi CHEN1, Yuanxin CHEN1, Xi CAO1, Zhisheng LAI3, Yufeng CHEN3, Yumei XUE2, Chen YANG1
Affiliations
  • 1School of Nursing, Sun Yat-sen University, Guangzhou 510080, China
  • 2Geriatric Medicine Research Institute, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510040, China
  • 3Yuexiu District Center for Disease Control and Prevention, Guangzhou 510040, China
Published: 2026-03-10 doi: 10.11847/zgggws1147236
Outline
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Objective

To analyze multimorbidity networks in community-dwelling elderly adults in Yuexiu district, Guangzhou and provide evidence to inform chronic disease management in community settings.

Methods

A total of 54 829 individuals aged ≥ 65 years who participated in the National Free Health Examination Program in Yuexiu district, Guangzhou from January to December 2020 were included. Python 3.14.0 was used for hierarchical cluster analysis of the multimorbidity patterns, and Gephi 0.9.2 was employed to visually analyze the multimorbidity networks. Subsequently, subgroup analyses were conducted based on gender and clustering results.

Results

The overall prevalence of multimorbidity in community-dwelling elderly adults in Yuexiu district, Guangzhou was 45.5% (24 922/54 829). The prevalence among males [44.2% (10 594/23 957)] was lower than that among females [46.4% (14 328/30 872)] (χ2 = 28.00, P < 0.001). Hierarchical cluster analysis identified 105 binary and 455 ternary disease combinations. The top three binary combinations were coronary heart disease (CHD) + hypertension (36.9%), hyperlipidemia + hypertension (18.6%), and gout + osteoarthritis (5.7%), while the top three ternary combinations were CHD + hypertension + heart failure (8.8%), bronchial diseases + chronic obstructive pulmonary disease (COPD) + asthma (2.3%), and arrhythmia + hyperlipidemia + osteoporosis (1.5%). Network analysis of 15 chronic diseases revealed a network consisting of 15 nodes and 87 edges, with a network density of 0.83. The core diseases were osteoarthritis, gout, and CHD, with weighted degrees of 2.9, 2.6, and 2.1, respectively. Gender-specific subgroup analyses showed that the network density for males was 0.78, with CHD, heart failure, and stroke as key hubs (betweenness centrality: 3.7, 3.7, and 3.1, respectively). For females, the network density was 0.83, with gout, hyperlipidemia, and osteoarthritis as key hubs (betweenness centrality: 2.3, 2.1, and 1.8, respectively). Clustering-based subgroup analysis showed that in the CHD + hypertension + heart failure group, hypertension was closely associated with CHD (weight: 0.39) and acted as the core disease (weighted degree: 0.73). For bronchial diseases + COPD + asthma, COPD was strongly connected to bronchial diseases (weight: 0.50) and served as the core disease (weighted degree: 0.77). In the arrhythmia + hyperlipidemia + osteoporosis combination, hyperlipidemia was associated with osteoporosis (weight: 0.07), with osteoporosis identified as the core disease (weighted degree: 0.11).

Conclusions

Multimorbidity is highly prevalent among community-dwelling elderly adults in Yuexiu district, Guangzhou, with complex interrelationships among chronic diseases. The multimorbidity network in females is more intricate than that in males. These findings highlight the need for community health institutions to implement targeted interventions tailored to gender differences.

chronic diseases  /  multimorbidity networks  /  elderly adults  /  network density  /  Guangzhou city  /  Yuexiu district
温文文, 热伊麦·艾山江, 黄俊, 陈致谊, 陈元欣, 曹希, 赖志胜, 陈昱丰, 薛玉梅, 杨琛. 2020年广州市越秀区社区老年居民慢性病共病模式:基于网络分析. 中国公共卫生, 2026 , 42 (3) : 295 -300 . DOI: 10.11847/zgggws1147236
Wenwen WEN, Aishanjiang Reyimai, Jun HUANG, Zhiyi CHEN, Yuanxin CHEN, Xi CAO, Zhisheng LAI, Yufeng CHEN, Yumei XUE, Chen YANG. Multimorbidity patterns of chronic diseases among community-dwelling older adults in Yuexiu District, Guangzhou, 2020: a network analysis[J]. Chinese Journal of Public Health, 2026 , 42 (3) : 295 -300 . DOI: 10.11847/zgggws1147236
Year 2026 volume 42 Issue 3
121
54
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Article Info
doi: 10.11847/zgggws1147236
  • Receive Date:2025-02-26
  • Online Date:2026-10-23
  • Published:2026-03-10
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History
  • Received:2025-02-26
  • Revised:2025-05-12
  • Accepted:2025-08-02
Affiliations
    1School of Nursing, Sun Yat-sen University, Guangzhou 510080, China
    2Geriatric Medicine Research Institute, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510040, China
    3Yuexiu District Center for Disease Control and Prevention, Guangzhou 510040, China

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YANG Chen, E-mail:
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表12种不同金属材料的力学参数
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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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