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

Wei Xin ^1,2* Dan Xu ^1,3 Zulin Dou ^2* Angela Jacques ⁴ Josephine Umbella ⁵ Yuling Fan ⁶ Longsheng Zhang ⁷ Haiwen Yang ⁶ Hong Cai ⁷ Anne-Marie Hill ⁵

• ¹ Curtin University, Perth, Australia
• ² Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
• ³ The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
• ⁴ University of Notre Dame Australia, Fremantle, Australia
• ⁵ University of Western Australia, Perth, Western Australia, Australia
• ⁶ Guangzhou Tianhe District Shipai street community health service center, Guangzhou, China
• ⁷ Guangzhou Tianhe District Linhe street community health service center, Guangzhou, China

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=6351). 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). Conclusions 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.