Abstract
This study examined gender-specific factors affecting multiple chronic disease burdens in Chinese adults over 45 years. This study was a prospective cohort study based on the China Health and Retirement Tracking Survey (CHARLS). A total of 6509 middle-aged and elderly people aged ≥ 45 years with 14 types of chronic diseases were included. The multiple disease burdens of middle-aged and elderly people were quantified using the China Multiple Disease Weighted Index. Longitudinal analysis shows that sleeping for more than 6 hours at night was a protective factor against the burden of multiple diseases, while female sex, an age > 60 years, overweight and obesity status, vigorous-volume physical activity (VPA) and poor self-reported health status were risk factors for the burden of multiple diseases. Based on a sex perspective, further subgroup analysis of the effects of body mass index, physical activity, and nighttime sleep duration on the burden of multiple diseases showed that female sex, obesity status and a nighttime sleep duration ≥ 8 hours were more strongly correlated with the burden of multiple diseases. The correlation between VPA and multiple disease burdens was greater in males. Longitudinal analysis shows greater correlations between female sex, obesity status, VPA, and a nighttime sleep duration ≥ 8 hours and multiple disease burden. The middle-aged and elderly population in China should pay attention to controlling overweight and obesity, limit excessive VPA, and ensuring that they, especially women, receive at least 6 hours of nighttime sleep, preferably 8 hours or more; men should receive at least 8 hours of nighttime sleep. Sex differences should be emphasized in chronic disease management.