Multimorbidity patterns and temporal trends of chronic diseases among community-dwelling older adults: Repeated cross-sectional surveys from 2022 to 2024

This study examined short-term trends in the prevalence of major chronic diseases, multimorbidity patterns, and of healthy aging levels among older adults participating in free health checkups in Longhua District, Shenzhen, from 2022 to 2024. Using random sampling, 10,000 participants were selected annually from the elderly health management information system, and both crude and age-standardized rates were calculated. Changes in prevalence were assessed using the Mantel–Haenszel test and multivariable logistic regression, while multimorbidity patterns were evaluated through network analysis and latent class analysis. After age standardization, the risks of hypertension (OR = 0.80, 95%CI: 0.75–0.85) and diabetes (OR = 0.88, 95%CI: 0.82–0.94) significantly decreased (both p < 0.001), whereas the risks of nonalcoholic fatty liver disease (OR = 1.11, 95%CI: 1.05–1.18) and stroke (OR = 2.67, 95%CI: 1.58–4.70) significantly increased (both p < 0.001). Subgroup analyses revealed that the oldest-old aged 70–79 years achieved the favorable control of hypertension and diabetes, while the prevalence of fatty liver disease rose significantly across normal-weight, overweight, and obese individuals. The centrality of diabetes and central obesity within the multimorbidity network increased in 2024, and the median healthy aging index improve compared with 2022 ( p < 0.001). In conclusion, although notable progress were observed in hypertension and diabetes management among older adults in this district, the rising burdens of fatty liver disease and stroke underscore the urgent need for enhanced early screening and targeted intervention for metabolic diseases and stroke, with particular emphasis on metabolic health management in individuals aged under 70 years and those who are overweight.