Abstract
BACKGROUND: With the global trend of population aging, China is witnessing a rapidly growing elderly population and an increasing burden of multimorbidity, which poses significant challenges to the healthcare system. However, research examining multimorbidity patterns that involve physical, psychological, and cognitive impairments remains limited. This study aims to explore the associations between leisure activities (LA), dietary diversity score (DDS), and body mass index (BMI) with the prevalence of physical-psychological-cognitive multimorbidity (PPCM) in older adults. METHODS: Data were derived from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), focusing on individuals aged 65 and above between 2017 and 2019. The prevalence of PPCMs was assessed using Chi-square and t-tests for group comparisons. Multivariable logistic regression and restricted cubic splines were employed to analyze the effects of LA, DDS, and BMI on multimorbidity. RESULTS: Among the 9,781 subjects included in the study, 43.41% presented with multimorbidity, with a notably higher prevalence observed in females. Multivariable regression analysis revealed that, when compared to the lowest quartile (Q1) of leisure activity (LA), the odds ratio (OR) for the highest quartile (Q3) was 0.601 (95% confidence interval [CI]: 0.529, 0.682). Similarly, the Q3 group of dietary diversity score (DDS) demonstrated an OR of 0.803 (95% CI: 0.721, 0.893), indicating a significant trend (Ptrend < 0.001). In terms of body mass index (BMI), the Q3 group exhibited odds of multimorbidity that were 1.084 (95% CI: 1.038, 1.133) times higher than those in Q1 (Ptrend < 0.001). Notably, LA displayed a nonlinear relationship with multimorbidity (Pnonlinear < 0.001), while BMI exhibited not statistically significant (Pnonlinear = 0.837). CONCLUSIONS: Effective measures for preventing PPCMs in the elderly may include maintaining a healthy BMI, promoting engagement in leisure activities, and encouraging dietary diversity.