Functional mobility and cardiometabolic multimorbidity: Evidence from the China health and retirement longitudinal study

Abstract

Background Population ageing has increased the burden of cardiometabolic multimorbidity (CMM), defined as the presence of two or more cardiometabolic diseases. Functional mobility is a marker of systemic ageing and adverse health outcomes, but its association with CMM remains unclear among Chinese adults. Methods Data were from 16,032 adults aged ≥45 years in the China Health and Retirement Longitudinal Study (2011–2018). Functional limitation was assessed using Activities of Daily Living and a seven-item mobility scale. The primary exposure was a standardised composite score based on the equal-weighted average of the two standardised indicators. PCA-derived, ADL-only, mobility-only, and Winsorised composite scores were examined in sensitivity analyses. Cross-sectional associations were estimated using multivariable logistic regression, and longitudinal associations using generalised estimating equations with time-varying covariates. Results Higher functional limitation was consistently associated with increased odds of CMM. In cross-sectional analyses, each standard-deviation increment in the functional limitation composite score was associated with 46% higher odds of CMM (odds ratio = 1.46; 95% confidence interval: 1.35–1.58; p < 0.001). In longitudinal analyses with time-varying covariates, the corresponding increase was 37% (odds ratio = 1.37; 95% confidence interval: 1.28–1.46; p < 0.001). A graded pattern was also observed across functional limitation tertiles. Conclusions Poorer functional mobility was associated with CMM among middle-aged and older adults in China in both cross-sectional and longitudinal analyses. Simple functional assessments may help characterize groups with greater cardiometabolic burden and may be useful in clinical assessment and monitoring in ageing populations.