Prevalence of Disability in Older Adults with Chronic Disease in Mainland China：a Meta-analysis

Abstract: Background　As global population continues to age，disability has become one of the most prominent health problems in the aging population. Chinese older adults with chronic diseases often diagnosed with multi-morbidities resulting in increased risks for disability. However，previous evidence on disability rates in this population have been inconsistent. Objective　To systematically evaluate the prevalence of disability in older adults with chronic diseases in mainland China. Methods　We searched databases including PubMed，Embase，Web of Science，Cochrane Library，Scopus，CNKI，Wanfang Data，VIP，CBMdisc and China Medical Journal Full-text Database up until August 2023 for publications on disability prevalence in Chinese older adults with chronic diseases. Literature screening，quality appraisal and data extraction were performed independently by two researchers. Meta-analysis was conducted using Stata 16.0 software. Results　A total of 32 publications（34 studies）were included. Sample sizes ranged from 221 to 16566 cases with a disability rate of 6.9%~82.8%. Meta-analysis showed that the prevalence of disability in Chinese older adults with chronic diseases was 43.2%（95%CI=32.9%-53.5%）. Subgroup analyses showed：（1）disability rate was higher in female（36.6%，95%CI=27.0%-46.2%） than in male（33.9%，95%CI=23.9%-43.9%）；（2）disability prevalence increased with age（60-69 岁：24.2%，95%CI=14.3%-34.0%；70-79 岁：34.9%，95%CI=24.1%-45.7%； ≥ 80 岁：47.7%，95%CI=36.3%-59.1%）；（3）compared to other chronic diseases，individuals with dementia/Parkinson's disease（56.3%，95%CI=40.9%-71.7%），mental illness（53.9%，95%CI=46.0%-61.7%），and cerebrovascular disease（49.2%，95%CI=33.5%-64.8%） had the highest prevalence of disability； and （4）the prevalence of disability increased with the number of comorbidities （1 disease：33.1%，95%CI=20.8%-45.3%；2 diseases：36.3%，95%CI=22.6%--50.0%； ≥ 3 diseases：49.7%，95%CI=31.3%-68.0%）. Conclusion　The prevalence of disability among Chinese older adults with chronic diseases is high and can be impacted by both the type of chronic disease and the number of comorbidities. It is recommended to strengthen chronic disease monitoring and management efforts to prevent and eliminate disability and promote healthy aging in this population.