Association between chronic diseases and lifestyle risk factors among community-dwelling older adults: a retrospective cross-sectional Chinese population-based study

Wei Xin; Dan Xu; Zulin Dou; Angela Jacques; Josephine Umbella; Yuling Fan; Longsheng Zhang; Haiwen Yang; Hong Cai; Anne-Marie Hill

doi:10.3389/fpubh.2025.1435385

Association between chronic diseases and lifestyle risk factors among community-dwelling older adults: a retrospective cross-sectional Chinese population-based study

Front Public Health. 2025 Mar 5:13:1435385. doi: 10.3389/fpubh.2025.1435385. eCollection 2025.

Authors

Wei Xin^#^{1

2

3}, Dan Xu^#^{1

4

5}, Zulin Dou^#², Angela Jacques^#⁶, Josephine Umbella^#³, Yuling Fan⁷, Longsheng Zhang⁸, Haiwen Yang⁷, Hong Cai⁸, Anne-Marie Hill^#³

Affiliations

¹ Curtin Medical School, Curtin University, Perth, WA, Australia.
² Rehabilitation Medicine Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
³ School of Allied Health, The University of Western Australia, Perth, WA, Australia.
⁴ Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
⁵ Medical Education and General Practice Department, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁶ Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia.
⁷ Medical Department, Guangzhou Tianhe District Shipai Street Community Health Service Center, Guangzhou, China.
⁸ Medical Department, Guangzhou Tianhe District Linhe Street Community Health Service Center, Guangzhou, China.

^# Contributed equally.

Abstract

Background: Chronic diseases among older adults are recognised as a serious public health problem in China, causing rising social and economic burden. The aim of the study was to evaluate the association between chronic diseases and lifestyle risk factors among community-dwelling older adults who attended community health service centres (CHSC) in Southern China.

Methods: A retrospective cross-sectional study (n = 361) was conducted using a random sample of cases from a primary care database registry of two CHSC in Guangzhou city, Guangdong province, China. The sample consisted of community-dwelling older adults aged 60 years and over who receive free annual medical examinations provided by the Chinese government. Data collected included biomarkers for chronic diseases, medical history, levels of physical activity, and lifestyle risk factors.

Results: There were 361 cases [mean age 74.65 (SD = 5.61) years] included in the sample (from total registry records n = 6,351). The top five chronic diseases were hypertension (55.68%), being overweight or obese (43.77%), hyperuricemia (40.60%), fatty liver disease (34.35%) and hypercholesterolemia (17.17%). Being overweight or obese was significantly associated with having fatty liver disease (OR = 1.22, 95% CI 1.05-1.41), higher WC was significantly associated with having hypertension (OR = 1.05, 95% CI 1.02-1.07), hyperuricemia (OR = 1.04, 95% CI 1.01-1.07), dyslipidemia (OR = 1.09, 95% CI 1.03-1.16), and fatty liver disease (OR = 1.22, 95% CI 1.05-1.41). Smoking was significantly associated with having hyperuricemia (OR = 2.40, 95% CI 1.13-5.07).

Conclusion: Data collected via medical examination identified the top five chronic diseases among older adults of Guangzhou city, China. Lifestyle risk factors are significantly associated with chronic diseases. Findings from the study will inform future design and evaluation of targeted, new services for these older adults. Further research to evaluate lifestyle interventions that can improve the health of older adults living with chronic disease is required.

Trial registration: Ethical approval ([2022]02-014-01) was obtained from the Health Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The study was registered on the Chinese Clinical Trial Registry Centre (registry number: ChiCTR2200066750).

Keywords: aged; chronic disease; community; public health; risk factors.

MeSH terms

Aged
Aged, 80 and over
China / epidemiology
Chronic Disease / epidemiology
Cross-Sectional Studies
Female
Humans
Hypertension / epidemiology
Independent Living* / statistics & numerical data
Life Style*
Male
Middle Aged
Retrospective Studies
Risk Factors

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study is funded by the National Key Research AND Development Program of China (grant no. 2020YFC2004205). Anne-Marie Hill is supported by a National Health and Medical Research Council (Australia) Investigator (EL2) Award and the Royal Perth Hospital Research Foundation. Wei Xin is supported by a Curtin University Fee Offset Scholarship for her PhD.