ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Self-Reported Health as a Predictor of Cardiometabolic Multimorbidity in Chinese Older Adults: A National Cross-Sectional Study
Provisionally accepted
- 1Affiliated Hospital of Shandong Second Medical University, Weifang, China
- 2Peking Union Medical College Hospital State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng, China
- 3Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 4Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
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Background: While self-reported health (SRH) robustly predicts clinical outcomes, its quantitative association with cardiometabolic multimorbidity (CMM) remains insufficiently characterized, particularly within low- and middle-income countries (LMICs). Aims: We aimed to quantify the dose-response relationship between SRH and CMM prevalence among older adults in China and to identify key sociodemographic effect modifiers. Methods: Utilizing cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyzed 9,762 participants aged ≥65 years (mean age 83.2 ± 11.3). SRH was categorized as good, neutral, or bad. CMM was defined as the presence of ≥2 conditions among coronary heart disease, stroke, diabetes, hypertension, or dyslipidemia. Multivariable-adjusted logistic regression assessed the SRH-CMM association. Stratified analyses evaluated effect modification by sex, age group, and residence (city/town/rural). Results: Declining SRH demonstrated a graded association with increased CMM prevalence. Compared to "good" SRH, "bad" SRH was associated with a four-fold elevated CMM risk (adjusted odds ratio [aOR] = 3.992, 95% confidence interval [CI]: 3.425–4.652), while "neutral" SRH conferred a two-fold risk elevation (aOR = 2.063, 95% CI: 1.835–2.320). Each one-level deterioration in SRH was associated withmore than a doubling of the odds (aOR = 2.009, p<0.001). The association was significantly stronger in males (aOR for bad vs. good = 4.441) than in females (aOR = 3.727), peaked among individuals aged 65-74 years (aOR = 4.785), and attenuated in centenarians (aOR = 3.441). City residents exhibited the highest risk elevation (aOR = 5.326, 95% CI: 3.961–7.163) compared to their rural counterparts (aOR = 3.662, 95% CI: 2.851–4.704; P-interaction = 0.006). Conclusions: SRH exhibits a strong, independent dose-dependent association with CMM burden in older adults, capturing cumulative biological aging beyond traditional biomarkers. Integrating SRH into clinical risk stratification may optimize preventive interventions for high-risk subgroups, particularly older city males and individuals reporting health deterioration.
Keywords: Self-reported health, Cardiovascular Diseases, Metabolic Diseases, multimorbidity, Aged
Received: 25 Aug 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Bing, Liu, Wang, Mao, Teng and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aihong Wang, wah15963419075@126.com
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